BY: SARAH ZUCKER

The Help Me Grow (HMG) National Center envisions early childhood systems that share power with the families they serve, are driven by
co-developed goals, and enhance conditions for promoting equity and inclusiveness.

This is a vision. And we have journeyed alongside many others within the early childhood field to arrive at it.

Over the last twenty-five years of HMG implementation, there has been an evolution in the approaches used to engage families, community-based partners, and child health care providers. Initial outreach and engagement efforts sought expertise from professionals who study communities and create policy recommendations. Then, in response to feedback such as “nothing about us without us”, community engagement activities increasingly began to solicit direct input from families with lived experience using tools such as surveys and focus groups. More recently, we have embraced a commitment to resourcing and supporting families in order to honor and compensate for their contributions in co-production and co-leadership.

A major initiative of the HMG National Center now tests how we can advance goal concordant care through HMG implementation. Originally a term used in palliative care meaning, “to provide medical care that honors a patient’s individual goals and values, and to align medical treatments with those goals of care”,^[1] we have worked to apply the term goal concordant care to early childhood:

Goal concordant care is a strengths-based approach to eliciting parents’ goals for their child’s well-being that elevates families’ goals as drivers in the process of developmental promotion, early identification of concern, referral, and linkage.

With the help of HMG Implementation Experts and the Childhood Prosperity Lab, the National Center worked to define a set of principles that underlie the concept of goal concordant care. From there, we thought through the myriad ways a HMG system might apply those principles to the Model’s Core Components and Key Activities.

In other words, we asked the question:

How can we do HMG in a way that most effectively elicits parents’ goals for their child’s well-being and ensures those goals drive decisions, referrals, and priorities for service delivery by all community-based providers working with a given family?

The principles we developed and the proposed enhancements to the Model can be found in
this framework.

So what comes next?

This week HMG National will release requests for applications to eligible systems to participate in a new learning community that will pilot test these goal concordant care-based enhancements to the HMG Model. 

The learning community will include four branches, one tethered to each HMG Core Component. Two to three HMG systems will be selected to participate in each of the four branches of the learning community. Participants and their local project partners will receive capacity building support from one of four national organizations leading the field in areas related to family leadership. Strengthened by this technical assistance, participating HMG systems will test the respective goal concordant care strategies tied to each Core Component branch.

A HMG system must be in full implementation of a given Core Component (as determined by HMG National Center’s 2021 Fidelity Assessment) to apply and participate in the respective branch of the learning community. Systems should only apply to one branch of the learning community, even if they are eligible for multiple; however, applying systems will be asked to indicate interest in any of the other branches for which it may be eligible. If eligible for multiple branches, HMG systems are encouraged to consider which branch may generate the greatest local impact as well as readiness to begin efforts in August 2022.

Individuals leading HMG systems that are eligible for one or more branches of the learning community will receive emailed invitations to apply.

Together we will test the proposed strategies to identify which ones are most feasible and have the greatest potential impact. These learnings will be disseminated across the National Affiliate Network so that all HMG systems can effectively use the infrastructure established by implementing the Model to partner with families in the pursuit of systems and services that are designed and delivered in accordance with families’ values, priorities, and goals at the center.

Sarah Zucker is the Manager of Communications & Network Relations for the Help Me Grow National Center at the Office for Community Child Health at CT Children’s Medical Center.

^{[1] Rutz Voumard R, Dugger KM, Kiker WA, Barber J, Borasio GD, Curtis JR, Jox RJ and Creutzfeldt CJ (2021) Goal-Concordant Care After Severe Acute Brain Injury. Front. Neurol. 12:710783. doi: 10.3389/fneur.2021.710783}