Creating Healthier Early Childhood Environments Together:A Systems Change Approach

Alison Patrick, MPH, RD, LDJuly 17, 2019

Funding Partners

Who we are…

Early Ages Healthy Stages is a partnership

between early care and education providers,

community organizations, health care, social

service agencies, businesses and families that

works collaboratively to make the healthy choice

the easy choice for young children and their

families.

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Our mission:

To work together to create healthy environments for

young children in Cuyahoga County.

Our vision:

Cuyahoga County is a community that provides all

children ages 0-8 with the opportunity to establish

healthy lifestyles in the environments where they live,

learn, sleep, and play.

Building a coalition means more than getting together once a month to talk

about our programs.

POLICIES Working with childcare centers, family care homes and other agencies to implement policies that improve health of young children and their families.

SYSTEMS Creating networks between gatekeepers and other key resources in the community. Changing the mentality of “how we do things around here.”

ENVIRONMENTS Making sure that the healthy choice is the easy choice through advocacy and legislation. Altering physical environments to make health accessible to all.

EAHS Strategic Plan can be found at:

www.earlyageshealthystages.org

Why Not Early Childhood?

• Food Access = Foodbank and ECE provider

partnership

• Healthcare Access = Cleveland Clinic Mobile Unit

and Headstart grantee partnership

• Family Engagement = Nutrition Education

business and Cuyahoga County Public Library

partnership

Shifting the System

Prioritizing the health of children ages 0-5 in our community

The Reality

• Stakeholder groups largely focus on how to prevent a problem through a policy, program, and practice lens

• Reality – rates of overweight and obesity and other health issues among children have stayed the same or gotten worse

Adapted from Hovmand, P. 2017

Systems Shift

• Stakeholder groups need to understand the drivers of health issues to inform not only what needs to be done but also howto do it effectively.

• Goal – activate and engage a group of stakeholders to begin shifting mental models and create the conditions for systems change

‘Upstream’ approach: EAHS ABC

EAHS Action Building Committee (ABC)

• Complimentary approach to the EAHS Coalition

• Recruitment approach:

– Multi-sector, diverse representation from the EAHS

coalition

– Must have been active in the EAHS strategic planning

process

– Able and willing to commit to full participate in the

process over the course of 9 months

Group Model Building (GMB)

• Used to build a shared understanding of

complex system

• Uses a set of sequenced activities to:– Visualize complex systems

– Understand how a problem changes over time

– Identify leverage points

– Set priorities for action

Identifying, visualizing, & understanding early childhood health in Cuyahoga County

Meeting 1:Hopes and fearsExpectation setting

May2018

Meeting 2:Behaviors over timeIdentifying important behaviors (trends) related to early childhood health

June2018

Meetings 3&4:Connection circlesLooking at variables that impact those behaviors, and connections between them

July & August2018

Meetings 5&6: Causal loop diagramsUnderstanding how and why those variables interact to impact the system of early childhood health

September & October2018

Meeting 7:Action ideasLooking for high-impact places and ways to intervene to improve child health

November2018

Meetings 8-10:Putting ideas to actionIdentify opportunities for action that have the greatest impact

December 2018 -February 2019

Systems insights and evidence-based practices to guide high-impact intervention

Group model building

What impacts or is impacted by the work of the EAHS Coalition?

Group model building

Coalition funding Overweight/obesityIntegration of

health/education

Group model building

Related variables…

…and how they connect

Goal: Integrate Ohio Healthy Program (OHP) into Step to Quality

• Long term goal

• Intended to continue facilitating connections between health and high quality early education

• Will require many actions steps over the course of the next few years

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Next Steps

• Scan existing ECE efforts

• Evaluate the impact of OHP on policies and practice

• Advocate and communicate about the value of OHP

• Create accountability in OHP between designations

Benefits of Our GMB Approach

• Increased community

engagement/partnerships

• Generated a call to action

• Provides a solid foundation for a future

strategic plan

• Assists with evaluation and outcome

planning

THANK YOU!

HOW TO KEEP UP WITH USWebsite: www.earlyageshealthystages.org Email: apatrick@ccbh.netFacebook: https://www.facebook.com/EAHSCuyahoga/Twitter: @EAHSCuyahoga

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