Documenting Family Goals: Help Me Grow Alaska Takes the “Strengthening Families” Approach to Goal Concordant Care

By Gabby Hamel

The Help Me Grow (HMG) National Center conducted a year-long Goal Concordant Care (GCC) Study to explore how aligning early childhood system support with families’ unique goals can improve outcomes for children. This approach shifted away from a traditional “needs-based” model and prioritized understanding and supporting families’ individual aspirations for their children.

The Study explored how to integrate GCC principles within the four Core Components of the HMG Model:

Centralized Access Point (CAP): This branch implemented motivational interviewing techniques, guided by the University at Buffalo Motivational Interviewing Center, to effectively elicit and document parents’ goals at the Centralized Access Point.
Family & Community Outreach: This branch partnered with Be Strong Families to utilize their Parent Café model, empowering caregivers to identify and pursue their own goals for their children.
Child Health Care Provider Outreach: This branch collaborated with Healthy Outcomes from Positive Experiences, a program of Tufts Medical Center, to implement an asset-based care framework and ensure a seamless “loop closure” on referrals related to parent goals.
Data Collection & Analysis: This branch engaged the Center for the Study of Public Policy (CSSP) to provide initial training and technical assistance on the Protective Factors Framework, guiding data collection and analysis efforts.

View the Goal Concordant Care Study Findings Report.

Taking the Strengthening Families Approach to Data Collection & Analysis

The Study took a unique approach to supporting families with young children. Instead of focusing exclusively on family needs, it centered on their goals, which were defined for this project as “relatively consistent aspirational aims, results, or achievements towards which a parent’s efforts on behalf of their child(ren), their family, and their role as a parent or caregiver are directed”. To understand how this worked, the Data Collection & Analysis branch of the Study used the Strengthening Families framework, developed by CSSP.

What is the Strengthening Families Approach?

The Strengthening Families framework is “a research-informed approach to increase family strengths, enhance child development, and reduce the likelihood of child abuse and neglect”, as described by CSSP. Think of it like this: strong families are like sturdy trees. They need strong roots to grow tall and healthy. These “roots” are called “protective factors.” The Strengthening Families approach focuses on building these five key factors:

Parental resilience: Managing stress and functioning well when faced with challenges, adversity, and trauma.
Social connections: Positive relationships that provide emotional, informational, instrumental, and spiritual support.
Knowledge of parenting and child development: Understanding child development and parenting strategies that support physical, cognitive, language, social, and emotional development.
Concrete support in times of need: Access to concrete support and services that address a family’s needs and help minimize stress caused by challenges
Social and emotional competence of children: Family and child interactions that help children develop the ability to communicate clearly, recognize and regulate their emotions, and establish and maintain relationships.

How Did the Study Support this Approach?

Before the Study began, many of the participating HMG Data Collection & Analysis (DCA) teams were already familiar with the Strengthening Families approach. To refresh everyone’s knowledge, CSSP conducted four training sessions between August and October 2022. These sessions focused on how the Strengthening Families approach, with its emphasis on five key protective factors, could be applied within the HMG Model.

Following these training sessions, CSSP and All Good Consulting provided personalized guidance to each HMG system team in the DCA branch. During these sessions, teams learned how to:

Understand and document parents’ goals
Share this information effectively with their networks
Ensure that these efforts strengthen families by building the five key protective factors

Building on these learnings, each DCA team then worked with local partners to create a customized action plan. These plans outlined how they would implement new approaches within their own communities.

HMG Alaska was one of the three participating HMG systems in this Learning Community branch. HMG National spoke with them to get an inside look at how HMG Alaska integrated the Strengthening Families approach into their work, the challenges they came across during the Study, and the impact this had on their system’s ability to identify and document parent goals.

National: To get us started, can you first describe HMG Alaska’s goal in participating in this GCC Learning Community branch?

HMG Alaska: Our system was interested in exploring ways to identify, document, and share parent goals for their children and families as a way to support, elevate, and advance their priorities. Our aim is to better understand families’ broader objectives – in addition to their short-term needs and concerns – so we can provide information, referrals, and service linkages that best support the achievement of parents’ goals. We felt that by collecting data on parent goals, we could also inform partnering HMG providers, service partners, and the state/community of common priorities that arise.

National: What kinds of enhancements did you make to your HMG operations during the Learning Community?

HMG Alaska: When we embarked on the GCC project, we were not entirely sure what it would look like to consciously pursue family goals from a data collection standpoint. Trying to quantify something as variable and often intangible as a family’s goal for their child or themselves was daunting. Because of the database platform we selected when we launched our HMG(Salesforce), we were able to pursue the idea of goal collection with the freedom to make changes to our data collection platform. Throughout the process, we made incremental changes to the database in order to track goal activity within a family case. With each change, we used the data collected to inform our next step. Because we already approached our service delivery within a family-led, strengths-based model, we approached the project with the assumption that we were already discussing goal information with families at least 75% of the time, just through our regular service-delivery method.

Our first change was to add a simple checkbox, which CAP staff were instructed to check anytime they discussed goals with a family. This allowed us to start the conversation with the CAP about what the GCC project was and explore how it might impact services to families. With the addition of the checkbox, we were able to discover two things: One, we were collecting goal information less frequently than we believed and two, the CAP staff did not have a shared definition of what “goal information” looked like in the context of the level of services provided by HMG Alaska. Our next step was to add an open text box to the database where CAP staff could document the family’s stated goal in their own words. We also spent time together as a team clarifying what “goal information” meant and discussing ways to solicit that information without going outside of the scope of the relationship HMG Alaska is intended to have with its clients. Shared definitions and parameters for exploring goals with families were established.

“Almost immediately, we started seeing an increase in the percentage of families where goal information was collected. CAP staff shared that just talking about goals as a group was enough to bring it to the forefront of their minds and make them think about what the family was sharing through a goal-tinted lens.”

We were then able to run reports drilling down on family goal information collected over a set amount of time. Reading through the information was informative and gave a general idea of what trends we were seeing from families in various areas of the state, but the narrative format of data collection was still incredibly difficult to quantify OR to share without potentially releasing situational information that could be considered identifying for the clients involved. We ultimately determined that we could categorize each family goal using the Protective Factors framework’s five protective factors. We created a drop-down menu within the database listing each of the protective factors and then had extensive discussions with the CAP staff to create “buckets” under each protective factor so various goal information was being categorized consistently by each of the Family Support Specialists. We were then able to create reports showing family goals based on the protective factor category that was impacted by the potential achievement of that goal.

National: What were the benefits of integrating these enhancements?

“Collecting family goal information gives depth to the limited interactions we have with families.”

HMG Alaska: Collecting family goal information gives depth to the limited interactions we have with families. We follow up to ensure they are connected to the services they were referred to, but more often than not, our interactions with a family are limited to a fairly narrow window of time. The ability to talk about how engagement with HMG Alaska impacts protective factors long-term by helping families reach or get closer to achieving their goals has been a remarkable way to show impact to the public. Being able to collect this kind of data, which often yields intangible results that we usually only talk about anecdotally, and report/discuss it with quantifiable data points is really impactful for audiences of both professionals and families served.

National: What challenges did HMG Alaska face integrating the enhancement into their HMG work?

HMG Alaska: Most of our challenges were experienced at the outset of the project. We were unclear on how we would use this information even if we collected it, and there were concerns across the board about honoring the family’s privacy if they chose to share their goals with us. Aside from those larger-scale questions, we encountered a handful of technical challenges such as: defining what “goal information” looks like, creating a clear framework that could be consistently applied for categorizing goal information, having shared definitions of the protective factors in relation to goal information, and identifying the best way to incorporate changes in the database that would be useful, streamlined, and allow for meaningful reporting while striving to ensure the added work for the CAP staff was manageable.

National: What approaches/strategies have been sustained to date?

HMG Alaska: Everything outlined above has been maintained to date. That includes all the changes we made to our database structure including adding the checkbox to denote when goal information is collected, the narrative box to document the goals in the family’s own words, and the primary and secondary drop-down menus with each of the five protective factors listed.

Conclusion

By centering on family goals and integrating the Strengthening Families framework into their data collection process, HMG Alaska was able to significantly enhance its approach to centering family goals and assets in their work. This shift from “family needs” to “family goals” in both intentional mindset and technical operations helped serve as a catalyst to families in developmental promotion efforts for their children while simultaneously strengthening key protective factors within the family system. Through careful data collection, analysis, and team training, HMG Alaska collected valuable insights into family aspirations, but also developed a more impactful and sustainable model for supporting child well-being across the state.

Want to learn more about the ways HMG connects to the Strengthening Families Framework?

Check out Help Me Grow: Strengthening Families and Supporting Caregiver Goals by CSSP.

Help Me Grow National Center