BY DR. PAUL DWORKIN
Heeding a Call to Action
As the COVID-19 pandemic began to accelerate, our Help Me Grow (HMG) National Center team members immediately began considering how to best address the needs of families during this crisis. In view of the voluminous responses of so many committed and capable organizations and groups across the nation, the team considered how to best ensure that any HMG response was meaningful and impactful, rather than merely adding to the rapidly overwhelming barrage of information and materials available to worried parents. The HMG National Center quickly concluded that any response should take advantage of its two unique and treasured assets: a strong, engaged, committed, and generous National Affiliate Network; and a portfolio of efficacious, unique innovations, interventions, and best practices that strengthen families through supporting parents’ essential role in promoting their children’s development, facilitating access to concrete supports, and enhancing resiliency.
The HMG National Center’s enthusiasm for a focus on its National Affiliate Network was tempered by uncertainty regarding the extent to which the National Affiliate Network had the capacity to engage amidst the unprecedented and daunting challenges faced by all affiliates and their HMG systems. The HMG National Center opted to distribute a survey to affiliates to identify families’ concerns and capture the innovative and critically important responses to addressing the most basic and vital of families’ needs. The large number of informative responses from the great majority of affiliates demonstrated the capacity of this engaged, creative, and committed professional network. Furthermore, responses documented the utility of the HMG Model as an effective vehicle to address families’ basic, pandemic-related needs.
The Evolution of the Model
While the utility of HMG as a response to the pandemic may appear surprising, the evolution of the HMG Model over several decades offers an explanation. When developed in the 1990s, the so-called “decade of the brain,” HMG was designed as a strategy to address the developmental needs of vulnerable children unlikely to meet states’ rigorous eligibility criteria for early intervention services. During this first decade, the HMG Model increasingly acknowledged the importance of parents as the key promoters of their children’s development and a focus on strengthening families’ protective factors to enhance children’s optimal health, development, and well-being.
With the onset of the new millennium came an increased awareness of the so-called “biology of adversity,” demanding attention to adverse childhood experiences, toxic stress, and social determinants of health. While the HMG Model continued to focus on early detection through surveillance and screening, as well as the referral and linkage of vulnerable children to community-based programs and services to address developmental and behavioral concerns, it has evolved in response to contemporary needs. For example, in many HMG systems, the Central Access Point has expanded to engage social sectors (e.g., child welfare) and address basic needs (e.g., transportation, housing, fuel sufficiency, food and nutrition). Furthermore, HMG systems are engaging diverse partners, such as the Build Initiative and the early care and education sector, as well as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Thus, while certainly unanticipated, affiliates’ pivot to address families’ basic needs during the pandemic may be viewed as a logical extension of evolving efforts to address disparities, promote equity, and strengthen families. In essence, the response of HMG affiliates to the pandemic is hardly surprising, and may even be viewed as predictable.
The Virtual Convening
On May 4, the HMG National Center convened a Help Me Grow National Affiliate Network COVID-19 Virtual Meeting. Approximately 150 individuals participated in the convening. Earlier correspondence had identified a range of extraordinarily creative and impactful approaches being undertaken by HMG systems to support families. Based on this information, the HMG National Center organized a series of focus group discussions on a range of priority topics, including how to optimize our support to families during this time, as well as emerging tools and resources that we should rapidly disseminate across the network. The discussions were exciting, inspiring, and exuded hope in a time of despair.
I was invited to reflect on the session at its conclusion. I opted to listen to the presentations and the ensuing discussion through the lens of the following question: “What are the approaches, activities, and policies being undertaken by affiliates in response to the pandemic that are likely to inform and/or be incorporated as routine and regular services, policies, and practices post-pandemic?” I challenged myself to limit my selections to five, and ultimately settled on six:
- The perilous status of community resources so severely impacted by the economic consequences of the pandemic emphasizes the critical importance of the maintenance of a vibrant, accurate, accessible resource inventory as a key attribute of the HMG Model.
- The pandemic’s exacerbation of families’ vulnerabilities as a consequence of adverse social, economic, and environmental disparities justifies the expansion of the scope of Central Access Points’ information and referral services to include meeting basic human needs.
- A pandemic-associated rise in such issues as domestic violence, child abuse, and emotional illness demands that the HMG Model continues to collaborate with all sectors critical to strengthening families and promoting children’s well-being.
- The adverse impact of COVID-19 on disadvantaged, underserved people of color demands that we declare our commitment to advancing equity in all that we do.
- The pandemic’s enforced rules of sheltering-in-place and the closing of community institutions such as schools and workplaces emphasize the importance of expanding access to technology for all members of society.
- Providers’ stress, despair, and anxiety in attempting to meet the needs of those they serve highlight the importance of ensuring self-care and supportive team-building among all staff.
The pivot of HMG affiliates to address the ravages of the pandemic while continuing, to the extent possible, their core functions is remarkable and inspiring. I have no doubt that our eventual return to a “new normal” will embrace many of the lessons learned during this horrific and unprecedented experience. We will continue to refine and evolve our HMG Model, in order to best enhance our efforts to strengthen all families to enable parents to promote all children’s optimal health, development, and well-being, with a special focus on those most vulnerable. My hope is that this evolution is the silver lining, as we begin to place this tragedy in some historical perspective.
Help Me Grow & COVID-19 is a blog series dedicated to sharing the ways in which the HMG National Center, National Affiliate Network, and national partners work together to ensure families are supported through the COVID-19 crisis.
Paul H. Dworkin, MD is the executive vice president for community child health at Connecticut Children’s, the director of Connecticut Children’s Office for Community Child Health and the founding director of the Help Me Grow National Center. Dr. Dworkin is also a professor of pediatrics at the UConn School of Medicine.