Health Equity through High-Quality, Aligned Preschool-to-3rd Grade Practices

Background: Healthy People 2020, a national framework for prioritizing health outcome for all Americans, has developed a number of goals to reduce health disparities via supporting healthy environments across all life stages. Education is a demonstrated lever in breaking cycles of poverty and promoting lifelong well being (Fiscella & Kitzman, 2009; Reynolds & Temple, 2008); however, key disparities exist in accessing high quality & aligned environments that undoubtedly promote positive health outcomes (Duncan & Murnane, 2011; Dowsett, Huston, Imes & Gennetian, 2008).

The Child-Parent Center (CPC) program is an evidence-based school reform model emphasizing quality and alignment through the provision of a series of family, school, and classroom support services (Reynolds, Temple, Ou, Arteaga & White, 2011). In 2012, the University of Minnesota received a federal i3 grant to scale and expand this model in linguistically, geographically, ethnically diverse contexts.

Three critical educational processes must be present in order to effectively promote healthy equity: equal access, quality of services and delivery, and alignment.

In order to promote healthy equity, all children must have equal access to high-quality, aligned educational services and experiences. Aspects of quality will be explored including both the provision of evidence-based services and strategies and their faithful implementation. Alignment focuses on the promotion of coordinating effective strategies across programs and services to reduce drop-off of early gains and boost potential health benefits.

Methods: This paper will explore quality, aligned school-based services of the CPC model as they relate to health outcomes. The CPC model has 6 key elements that each independently and together promote health-related quality of life indicators: 1) Collaborative Leadership Team, 2) Parent Involvement, 3) Aligned Curriculum, 4) Effective Learning Experiences, 5) Professional Development & 6) Continuity & Stability (Reynolds et al., 2014). Each element consists of several indicators that directly and indirectly support children’s well being.

Results and Conclusions:  Implementation of the 6 elements occurred with relatively high levels of fidelity. Effective learning experiences, parent involvement, and collaborative leadership were associated with positive child outcomes in preschool and kindergarten. We will review a logic model that outlines the process between inputs (i.e., CPC elements), outputs (e.g., creation of positive social and physical learning environments), and short-, mid-, and long-term health outcomes and well being. Through the identification of potential mediators & moderators, we propose a series of pathways between early experiences to later health outcomes and lifelong well being. Initial findings indicate that scale up and sustainability of the program can promote improved achievement and health. Policy implications will be discussed and will include direct connections to Healthy People 2020.