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THE
the
FAMILY SUPPORT AND PARENT EDUCATION:
OPPORTUNITIES FOR SCALING UP
By Rima Shore
Report of a Meeting Convened
by Carnegie Corporation of New York
November 16-17, 1994
From time to time Carnegie Corporation supports
meetings on issues of importance that may or may not
be closely related to its grant programs. Occasionally,
reports of these meetings merit public dissemination.
CONTENTS
FOREWORD
i
INTRODUCTION
1
PART I. THE STATE OF THE ART
2
THE PROBLEM: A PATTERN OF NEGLECT
2
Meeting the Needs of Preschool Children
3
Concerns of Parents
4
Research on the Status of Children and Families
5
THE SOLUTION: BUILDING PARENTAL COMPETENCE
6
Local Efforts
6
State-sponsored Efforts
6
Federal Efforts
6
Types of Family Support Programs
7
Examples of Family Support Programs
9
IMPACT OF FAMILY SUPPORT AND PARENT EDUCATION: THE EVIDENCE
11
THE CHALLENGE: MOVING FROM PROGRAMMATIC TO SYSTEMIC EFFORTS 12
PART II. LESSONS LEARNED
14
THE MAJOR SERVICE SECTORS
14
Child Care
14
School-based Programs
15
Welfare
17
Health
17
Criminal Justice
18
MAINSTREAM INSTITUTIONS
19
Faith Institutions
19
Business
21
The Media
22
GOVERNMENT
23
Federal Government
23
State Governments
24
Local Governments
25
PART III. GOING TO SCALE
27
DEFINING "SCALING UP"
27
CREATING SYSTEMS OF SERVICES
28
SCALING UP PARTICIPATION
28
SCALING UP EVALUATION
29
LESSONS LEARNED FROM CURRENT EFFORTS
30
FOCUS ON QUALITY
31
ENDNOTES
33
REFERENCES
36
APPENDIX A: Agenda
APPENDIX B: List of Participants
FOREWORD
P
arenthood is a very big job - a huge investment of time, energy, and sustained attention
to childraising; and a great learning experience. But the process is far from simple - and
now it is more complicated than ever.
In the United States, the structure and function of families have undergone profound
changes in just the past thirty years. Some of these changes represent new opportunities and
tangible benefits. Others place the well-being of children in such jeopardy as to pose a
problem for the entire society. One striking change from the perspective of child development
is the widespread entry of mothers of preschool and school-age children into the paid
workforce - now reaching about 60 percent. Another change is the growth of teenage
parenthood. Although the birthrate for adolescents has leveled off, each year teenagers give
birth to nearly half a million babies. Yet another drastic change is the large number of
children growing up with only one parent; indeed, most American children today spend at
least part of their childhood in a single-parent family.
By and large, young people moving toward parenthood today are far less experienced
in the care of children than were their grandparents; they spend less time with their children
than previously; and a majority of parents report they are less willing than were their parents
to make key sacrifices for the next generation.
However much the American family has been transformed in the latter twentieth
century, it is still the fundamental unit responsible for the health, education, and general well-
being of children. Whatever has happened to it, the family is still the central organizing
principle of the society. But families do not function in isolation. To be successful, they need
an appropriate social environment - one that provides supportive social networks, a firm sense
of community, mutual aid, and a feeling of belonging.
In view of the drastic family dislocations of recent decades, the traditional sources of
family support have been seriously weakened. Increasingly, other institutions and
organizations of society are stepping in with programs to help prepare young people for
responsible parenthood, build parental competence, and strengthen the family through new
supportive systems. The potential of these programs to fill in the gaps and help meet the basic
needs of families and children is enormous. But they must become more widely available.
In November 1994, Carnegie Corporation drew together a group of experienced
professionals in the domains of parent education and family support to review the experience
of programs offered by schools, health care institutions, faith organizations, the private sector,
nonprofit organizations, and government to strengthen parents' ability to care for themselves
and their children and to consider the requirements for "scaling up."
We are most grateful for the participation of these experts over two days of intensive
discussion. We further thank Rima Shore for preparing this extremely fine report synthesizing
the proceedings and the relevant literature, and Michael Levine, program officer in the
Corporation's Children and Youth program, for overseeing the development of the report.
Kathryn Taaffe Young, senior program officer at Commonwealth Fund, played an important
role in organizing the conference. It is our hope that the report will stimulate serious thought
and practical action on ways to bring parent education and family support to all who need it.
David A. Hamburg, President
Carnegie Corporation of New York
ii
FAMILY SUPPORT AND PARENT EDUCATION:
OPPORTUNITIES FOR SCALING UP
By Rima Shore
Report of a Meeting Convened
by Carnegie Corporation of New York
November 16-17, 1994
M
ost Americans live and raise children in family units. In fact, the United States
population encompasses more than 67 million families with children under the age of
eighteen.¹ To be sure, these families vary in structure, size, and self-description. But to a great
extent people in every sector of American society are recognizing that the conditions and
experiences that most directly affect children's lives are embedded in the contexts of families.
Decision makers are acknowledging that if their policies are to address the urgent needs of
children, families must be systematically supported.²
Today, some of the resources traditionally available to young families - the kind of
help and skills shared among large extended families and close-knit communities - are no
longer within the reach of many Americans. A wide range of institutions and agencies, private
and public, have been working to fill the void. They now offer an array of services and
interventions designed to strengthen families and to impart the knowledge and skills that can
help parents fulfill their role with greater confidence and competence.
On November 16-17, 1994, Carnegie Corporation of New York convened a meeting
to discuss the lessons learned from existing initiatives and to examine strategies for scaling up
successful efforts. This meeting gathered individuals with expertise in some aspect of family
support or parent education: independent researchers, academics, government policymakers,
decision makers from the various service sectors, and leaders representing faith organizations,
the media, and business. This report compiles the ideas, facts, trends, conclusions, and
recommendations that emerged at the meeting, drawing as well on background documents and
relevant data.
Part I of this report outlines the case for strengthening families, provides a broad
overview of existing family support and parent education efforts, summarizes findings on the
effectiveness of these programs, and discusses the challenge of moving from programmatic to
more systemic efforts. Part II summarizes the lessons learned from existing initiatives in every
sector of American life, including the major service sectors (child care, education, health,
welfare, and criminal justice); mainstream institutions (faith institutions, business, and the
media); and government (federal, state, and local). Part III presents the challenges of going to
scale.
PART I. THE STATE OF THE ART
THE PROBLEM: A PATTERN OF NEGLECT
The springboard for the discussion of scaling up family support programs was the 1994 report
issued by Carnegie Corporation of New York, Starting Points: Meeting the Needs of Our
Youngest Children. Starting Points presented the scientific evidence that has accumulated over
the last decade confirming what parents and teachers have long suspected - that children's
early care and environment have a decisive, lasting effect on their later development, including
not only their physical development but also their intellectual and emotional growth. It
documented a pattern of neglect that threatens the well-being of young children and of the
society they will inherit.
Starting Points found that when women and men are prepared for the opportunities
and responsibilities of parenthood, they are more likely to provide the care and create the
conditions that promote healthy development. It emphasized that the kinds of knowledge that
can help parents give their children a good start in life - knowledge about child development
and child health, for example - does not come naturally; nor is it always available from
relatives or neighbors. For this reason, virtually all parents can benefit from the kinds of
information and guidance that help them understand and respond to their children's physical,
intellectual, and emotional growth, particularly in the first three years of life when
development proceeds at such a dizzying pace. This finding is borne out by the fact that,
across the nation, families at all income levels and in all kinds of communities - urban,
suburban, and rural - are taking advantage of existing family support services.³
2
Meeting the Needs of Preschool Children
While parents of school-age children can certainly profit from family support, parents of
infants and toddlers may benefit the most. And since the number of children under age five
has increased sharply in recent years, rising by 18.6 percent from 1980 to 1993, more and more
parents are struggling to meet preschoolers' needs.4 At times, those needs seem relentless.
Compared to the young of other species, human children are remarkably helpless. The very
survival of the human species therefore hinges on adequate parenting throughout an extended
childhood (although parents who are trying to comfort a wailing newborn at three A.M. or
reason with a thrashing three-year-old who will not get into her car seat may have more
doubts about their own survival than that of their child).
And yet, parents must do much more than safeguard their children's (and their own)
physical health and safety; they must also provide for their emotional, intellectual, social, and
spiritual development and well-being. As their children grow, parents must continue to
provide a sense of safety and structure, belonging, self-esteem and self-reliance, intimacy and
relatedness, and competence.⁵
Parents must accomplish all of this while running busy households and holding down
jobs. Today, approximately 60 percent of mothers are in the work force. Half of those have
babies under one year of age. The number of mothers of preschoolers in the labor force has
doubled over the last quarter century. In 1993, there were 9.6 million working women with
preschool children.6
Parenthood can overwhelm even the most mature mothers and fathers; it is certainly
stressful for the nation's large number of very young parents. Very recently, the birthrate for
adolescents has decreased slightly, although the problem remains serious. Each year teenage
mothers give birth to nearly 500,000 babies. Today, 3.3 million children live with adolescent
mothers. These young mothers have a particular need for parent education and support. They
are much less likely than other mothers to take advantage of prenatal care, and those under
age seventeen are more likely to have low-birthweight children - with all of the health and
developmental problems associated with that condition. In general, children born to teenage
parents, especially those living with their mothers alone, appear to be more likely than other
children to have continuing health problems.⁷
3
For all of these reasons, Starting Points recommended that community-based parent
education and support be available on a voluntary basis to all parents with children under age
three. It called for programs that increase understanding of child development and
parent-child relationships, provide models of parenting, and teach parenting skills. The report
stressed the importance of continuity - maintaining ongoing relationships with parents;
flexibility - creating services and supports geared to the strengths, styles, and needs of
individual families; and outreach - linking families with other parents and with community
resources.
Concerns of Parents
Few jobs are more vital to the well-being of children and society as a whole than parenthood;
yet few jobs are undertaken with so little solid information or training. Many Americans have
more resources in their homes for operating a new appliance, such as user manuals, on-screen
instructions, or toll-free customer support numbers, than for coping with a new baby.
This might not be alarming if parents and children were faring better. But participants
at Carnegie Corporation's meeting pointed to numerous, well-documented signs that many
American families are in crisis and that the trajectory toward trouble may be set even before
birth. Some of this evidence comes from parents themselves. Torn between the need or desire
to work and to care for their children, many mothers and fathers are worried - sometimes
guilt-ridden - that they do not have more time, more energy, more patience. Two-thirds of
employed parents with children under eighteen say that they do not have enough time for
their children.⁸ More than half - 55 percent - say that they are not doing as good a job at
childrearing as their own parents did.9
American parents are hungry for information and advice, a fact that has not been lost
on publishers, which have stocked bookstore shelves with scores of titles on pregnancy and
childbirth, child health and development, and childrearing. Parenting magazines, numbering
close to one hundred separate publications, are thriving. Many parents are also going on-line,
perusing electronic bulletin boards for advice about teething or toileting, finding child care,
or coping with sleep deprivation. A measure of parents' desperation is their eagerness to call
helplines. A single 800 number supported by corporate employers has been called by more
than two million parents. Even some of the corporate decision makers who established the
helpline have expressed surprise that so many parents are willing to rely on the guidance of
4
strangers. In short, vast numbers of Americans, representing every socioeconomic and ethnic
group, are worried about their parenting and are eager for information and support.
Research on the Status of Children and Families
Over the last two decades, research on the status of children and families in the United States
has confirmed parents' fears: that in too many cases our children's most basic needs are not
being met in their family settings. The data gathered in Starting Points indicate that despite
a great deal of knowledge about caring for young children the nation is not yet able to assure
their physical safety or survival. The risk to children's health and safety begins before birth.
In 1990, one in four pregnant women received inadequate prenatal care, and the number of
mothers who receive virtually no care during pregnancy is rising.¹⁰ As a result, the United
States has a worse low-birthweight rate than thirty other nations and a worse infant mortality
rate than nineteen. Childhood injuries are the leading cause of death among children ages one
through four. Many of these injuries are accidental; too many are not. In 1990 more than 2.5
million children were reported as being abused or neglected in the U.S. One in three victims
of child abuse was a baby less than a year old.
Millions of other small children may be physically safe and healthy but may face other
kinds of risks that jeopardize their emotional, social, and cognitive development. Recent
studies have found that the vast majority of child care programs in this country - 70 to 80
percent - are of mediocre or poor quality. The quality is even worse for infants and toddlers.
The services available are too fragmented and too poorly funded to provide adequate coverage
or quality to meet the needs of an expanding and changing preschool population.¹¹
These and other problems cut across all social and economic strata but are more
common among children of poor, teenaged, and single parents and among women who have
rapid successive pregnancies. Many of these problems can be linked to poverty. For example,
children from low-income homes are at significantly higher risk for infant mortality, low
birthweight, physical or mental disabilities, fatal accidents, and common health problems such
as asthma, frequent diarrhea, pneumonia, or decayed or missing teeth.¹² These findings are
especially sobering in view of the fact that the number of children living in poverty is large
and growing. Today, one in four infants and toddlers under the age of three - nearly 3
million children - lives in a family with an income below the federal poverty level.
5
THE SOLUTION: BUILDING PARENTAL COMPETENCE
The challenge posed by Starting Points is to identify, replicate, and expand programs and
services that build parental competence and strengthen families. The group that gathered in
November 1994 took up this challenge.
Most individuals and institutions committed to family support and parent education
envision a future in which these services are available to every family that wants or needs
them. While that remains a distant goal, enormous strides have been made over the last
decade.
Local Efforts
A national database of family support programs from the Family Resource Coalition, which
is not exhaustive, lists hundreds of local programs. Surveys by the Robert Wood Johnson
Foundation have documented the existence of more than 2,000 organizations that characterize
their mission as providing family support.
State-sponsored Efforts
In the mid- to late 1980s, statewide parent support initiatives were launched in various parts
of the country, including Missouri's Parents as Teachers program, Maryland's Friends of the
Family and Family Support Centers, Connecticut's Parent Education and Support Centers, and
Minnesota's Early Childhood and Family Education Program. These programs differ in their
content, structure, staffing, and relative degrees of central authority and local autonomy.
Maryland has primarily targeted teen parents and their families; the other three states offer
services to all parents with young children. But each of them offers a basic menu of core
services, and all allow some local flexibility." These and other programs constitute persuasive
evidence that family support principles can be translated into effective, politically viable
policies at the state level. 14 A recent typology of family support programs documented state-
sponsored family support programs in twenty-one states. These large-scale efforts provide
services at numerous sites, with a view toward eventually offering them on a statewide basis.¹ 15
Federal Efforts
Several federal educational initiatives aim to strengthen parent involvement. One, the Even
Start Program (part of the Elementary and Secondary Education Act of 1965), helps mothers
6
and fathers develop parenting and literacy skills while providing good-quality early childhood
programs. Recent non-legislative activities undertaken by the Clinton administration have
included building a Family Involvement Partnership for Learning, which pulls together groups
from many sectors to find ways to deal with family support issues.
Types of Family Support Programs
Family support and parent education programs have many sponsors and funders. They may
be organized by faith organizations, schools, hospitals, or health clinics. They may include
child care centers, parent hot lines, visiting nurse services, mental health centers, pediatric
intervention teams, correctional facilities, Big Brothers or Big Sisters programs, crisis centers,
community action agencies, employment and training centers, and dozens of other
organizations. These agencies and programs have different histories, grow out of different
disciplines, and draw their staffs from different educational backgrounds. For this reason, they
conceptualize their work differently. The common link is that the services they provide are
designed to strengthen parents' ability to care for themselves and their children.
Meeting participants noted that people tend to be most receptive to information or
advice at times of decision or transition. For this reason, the timing of family support/parent
education services is crucial. Three key transition points for young parents and young children
are birth and the perinatal period; the initial adjustment to out-of-home care; and the transition
to school. Most family support programs target at least one of these transitions. Depending
on the timing and nature of the intervention, programs may be home-based, institution-based,
or multifaceted.
Home-based programs. Rooted in the friendly visitor tradition of the last century,
the concept of home visitation rests on the premise that to foster the early development of
children, particularly at-risk children, one needs to work with parents in their home, observing
their interactions with their child in a natural setting and helping them to create an
environment from the outset that will support the child's healthy development. The services
may be offered through community-based organizations, preschools, health clinics, or
neighborhood family-child centers. The visitors may be nurses, social workers, or parent aides.
Some family support programs use home visits as the sole or main type of intervention;
in fact, these programs appear to be proliferating.¹⁶ They may vary in terms of the goals they
are pursuing, the particular information or skills they stress, the frequency and duration of
7
visits, and the characteristics of the visitors and the clients. But most home visiting programs
focus on parents' ability to provide the basic requirements for food, shelter, and health care
and to meet children's emotional, intellectual, and social needs. They teach and demonstrate
how to enhance parent-child interactions, create a safe, appropriate home environment, and
access health care and other services.
Because they occur in the home where family life takes place, home visitation programs
offer many advantages, which were discussed in some depth at the November meeting. Home
visits allow clients to receive services without traveling to an office or arranging for child care.
They encourage a very broad view of a family and place childrearing practices in the context
of their particular community and circumstances. By demonstrating their willingness to go
to the family's turf, visitors build a trusting relationship and create a "therapeutic alliance" -
a supportive, ongoing relationship that fosters parents' growth. In all of these ways, home
visits can potentially shift the ecology of family life, helping parents make the kinds of changes
that they themselves want to make.
Meeting participants also observed that home visits also have some drawbacks. In high-
crime areas, they may pose dangers to visitors. They may also be perceived as intrusive or
intimidating by parents, who may not want to expose their home lives to the scrutiny of
strangers. The substance, scope, or quality of visitors' work may be difficult to supervise. In
addition, home visits often present professional dilemmas, such as how to establish trust
without encouraging dependency. Some organizations now make use of "personal visits,"
which may take place at home or at a church, a neighborhood family center, a restaurant, or
wherever the family and the visitor can get together.
Institution-based programs. Other family support programs are based in insti-
tutions, such as child care centers, schools, community colleges, or health clinics. These
institutions may integrate family support with their core services, either making their existing
services more family supportive or adding a family support component to their spectrum of
services. Among the more intensive efforts are school-based programs for young mothers and
their babies. These programs usually supplement instruction, provided in appropriate
classroom settings, with personal guidance and mentoring from teachers, nurses, and social
workers. During pregnancy, the students receive routine prenatal care and are under the
supervision of nurses. The school curriculum includes subjects like planning for self-sufficiency
and delaying subsequent pregnancy. This type of program has been shown to increase the
8
likelihood of healthy pregnancies and having healthy infants, while reducing the risk of welfare
dependence. Students who begin the program early in their pregnancy show the best results.¹⁷
Multifaceted programs. Discussion at the Carnegie Corporation meeting reflected
the widespread conviction among family support advocates that neither home-based services
nor institution-based services, as stand-alone strategies, are sufficient. A decade of research
indicates that the most effective efforts take a more comprehensive approach, providing a range
of services at home and in the community. Some of these programs, particularly those
sponsored by state governments, are large in scope; others are more limited. But most provide
a basic menu of core services, including prenatal care and counseling; parent education covering
child development and a wide range of parenting skills; home visits; drop-in centers; parent
support groups; structured playtime for parents and children; information and referrals; and
counseling. Some programs also provide parent employment training and counseling, health
care, and child care for infants and toddlers.
Examples of Family Support Programs
Among the larger, more well-established family support programs are the following:
Parents As Teachers (PAT). A program for parents of children up to three years of
age, PAT is the largest comprehensive family support program in the nation. The PAT model
emphasizes regular home visits and individual contact with the parents. The state of Missouri
requires every school district to offer the program. An evaluation of PAT in thirty-seven
Missouri school districts found that participating three-year-olds scored above the national
norms on language and on school-related success.
Healthy Families America (HFA). This Chicago-based program adapted the innovative
Healthy Start initiative that originated in Hawaii a decade ago. Established in 1992 by the
National Committee to Prevent Child Abuse, in partnership with Ronald McDonald House
Charities, HFA is the nation's fastest-growing family support program. It has spread to more
than 170 communities in twenty-nine states and the District of Columbia. HFA provides home
visitor services to new parents and stresses continuing staff education and credentialing. It has
implemented a quality assurance plan for all sites and is now developing a family support
research network.
9
Birth to Three. Founded in 1978 in Eugene, Oregon, Birth to Three brings new
parents together to share experiences, learn about child development, form a support network,
and gain access to community resources. Programs are community- or school-based and are
run by professional staff assisted by volunteers. The program is open to all families in Oregon
and, to date, has involved more than 10,000 families.
Home Instruction Program for Preschool Youngsters (HIPPY). HIPPY serves parents
of four- and five-year-olds in over two hundred communities in twenty-two states. Parent
aides visit participating families at home twice a month over a two-year period; they present
and model a curriculum of activities for parents to follow with their children. Twice-monthly
group meetings led by a professional program coordinator help parents share educational
approaches to use with their children. A study that followed participating children through
their school careers until grade ten concluded that HIPPY has a positive, sustained impact on
achievement and adjustment in school.
Avance. Founded in Texas in 1973, Avance serves low-income Mexican American
families and their young children. It offers classes for mothers and fathers, day care for the
children, and in-home visits from educators. Evaluations show that as a result of their
participation in the program, parents provide more educationally stimulating and emotionally
supportive home environments for their children, use less restrictive and punitive discipline,
and make greater use of community resources.
MegaSkills Program. This is a less intensive model that offers workshops for parents
to help them carry out learning activities at home. It has trained more than 4,200 workshop
leaders from forty-five states. Evaluations of children whose parents have received MegaSkills
training show improvements in the children's achievement test scores, attendance, time spent
doing homework, and time spent with parents.
Minnesota Early Learning Design (MELD). This Minneapolis-based organization helps
new parents improve their child-rearing skills and promotes children's development by
disseminating training and curriculum programs that have been adopted in more than 150
educational and social agencies in twenty-five states. MELD's parenting education programs
have been used successfully to support the healthy growth and development of children with
disabilities, new immigrants, and adolescent mothers. Research on these programs has revealed
reduced family isolation and improved parenting skills.
10
Parent-Child Centers. This initiative originated in the 1960s as a key component of
the Head Start program. The program was cut back dramatically in the 1970s but has grown
slowly over the past two decades. In 1992 there were 106 centers serving roughly 20,000
children under the age of three. The program combines home visits beginning during
pregnancy; activities geared to teen parents and their families; high-quality child care; and early
intervention for children with special needs.
IMPACT OF FAMILY SUPPORT AND
PARENT EDUCATION: THE EVIDENCE
Research conducted over the last three decades suggests that a significant portion of the
problems afflicting the nation's children can be tied to parental behavior - in particular, the
health-related behaviors of pregnant women - and to the quality of care that parents provide
to their children.¹⁸ The question remains: Can family support and parent education programs
strengthen parents' ability to care for their children and thus improve results for children?
The evidence is promising but not conclusive. Comprehensive, multifaceted family support
programs are difficult to evaluate: they encompass many variables, and they try to gear services
to the needs of individual families. Because different programs work with children of different
ages and target different kinds of families, it is difficult to compare them. For these reasons,
there has been little systematic research on their effectiveness.
On the other hand, evaluations of more narrowly focused programs - those stressing
home intervention and parent education - indicate that their effects can be impressive.
Effective programs begin with prenatal care; they are comprehensive, intensive, and long
lasting. Such programs appear to be particularly helpful to low-income, single, adolescent
mothers, whose children are at high risk for academic failure and a multitude of other
problems. Research shows that it is possible, although difficult, to improve results for these
children while reducing the risk of welfare dependence, antisocial behavior problems, and
violence.¹⁹
Meeting participants noted that home intervention programs appear to be a particularly
promising approach. Studies conducted over the last ten years have produced some evidence,
based on a small number of high-quality research and demonstration programs and well-
evaluated service programs, that regular home visits can enhance children's, and sometimes
parents', development. Two large studies conducted in Elmira, New York, and Memphis,
Tennessee, suggest that early childhood home visitation services can reduce poor pregnancy
11
results and dysfunctional caregiving as well as lower the risk of welfare dependence and youth
violence among low-income families. Home visitation programs also appear to be cost-
effective. One study showed that, by the time they reached age four, children in low-income
families who received home visitation from the prenatal period through the second year of life
cost the government $3,313 less than did their counterparts who received no services.²⁰
The research further suggests that the effects of home intervention programs during the
preschool years can persist over an extended period. Some longitudinal studies show that IQ
gains associated with such programs persist into the elementary school years. These gains do
tend to fade after several years, but researchers note that the boost during the crucial "school-
readiness" years may contribute to subsequent achievement.²¹
Efforts that focus on helping parents become stronger partners in their children's
learning have been shown to have a significant positive impact on children's cognitive
development, school performance, and social functioning. Numerous studies over the last
three decades have shown the promise of programs designed to assist parents of preschool
children, including family literacy programs, projects that integrate adult and early childhood
education, and family intervention programs designed to help parents become better partners
in their children's schooling.²²
THE CHALLENGE: MOVING FROM
PROGRAMMATIC TO SYSTEMATIC EFFORTS
The literature on family support and parent education refers frequently to an evolving family
support "movement." This usage reflects the fact that many researchers and practitioners in
the evolving field of family support are joining forces - in professional organizations and
publications and at conferences and other public forums - to urge a shift in emphasis from
programmatic family support efforts to a more systemic approach. Family support advocates
have begun to press decision makers in many spheres of public and private activity to infuse,
into their organizations' policies and practices, a set of family support principles that include:
1) an emphasis on prevention, resulting in programs that do not just treat problems but seek
to prevent them; 2) an ecological approach, resulting in programs that take into account the
needs and conditions of the child, family, and community; 3) a developmental view of
parents, resulting in programs that support the growth and learning of parents as well as
children; and 4) a belief in the universal value of family support, resulting in programs that can
strengthen and empower all kinds of families.²³
12
Organizations can also infuse into their policies and programs some of the best practices
of effective parent education programs, including efforts to establish and maintain ongoing
relationships with parents; gear services to the strengths, styles, and needs of individual
families; model positive parent-child interactions; teach new parenting skills; increase
understanding of child development; provide a network of social support with other parents;
and facilitate parents' access to community resources.
The family support "movement" proceeds from the premise that family support and
parent education cannot succeed as isolated efforts. In particular, families living in poverty and
in conditions of constant stress have urgent needs that stand-alone programs or parenting
classes alone cannot meet. To serve these families, parent education and family support
programs must be embedded in a coordinated array of community-based services including, but
not limited to, health care, child care, literacy classes, and job training.
A number of the larger, more well-established programs have attempted to move in the
direction of systemic reform by providing training and technical assistance to community-based
agencies or school districts that wish to provide more support to the families they serve.²⁴
Their aim is to move, over time, to a model of family support that encompasses all of the
services available in a given locality. In this sense, the family support movement is allied with
"coordinated services" efforts in education, which have gained momentum in recent years.
Informed by a growing network of advocates and practitioners, the coordinated services
movement tends to focus on school-community linkages, envisioning the school as a hub of
services - including education, health, recreation, and social services - for all the residents in
its vicinity.25
The family support movement seeks to reconfigure delivery systems as well, with an
emphasis on services to young families. Existing services derive from multiple antecedents and
many disciplines and are supported by many different funding streams.²⁶ The crazy quilt of
delivery systems now in place, particularly for poor children, rarely meets the needs of the
"whole child" or the "whole family."2 The comprehensive, multifaceted programs that are
now operating in many parts of the country have taken strides in that direction, by reaching
out to local service providers and helping them to incorporate family support principles into
their day-to-day work. But they cannot address directly the obstacles that tend to undermine
efforts at coordinating and transforming delivery systems, such as categorical financing,
interagency turf battles, and political conflict.
13
Despite these limitations, comprehensive programs are putting down roots in many
parts of the country and offer many opportunities for scaling up family support and moving
toward a more systemic approach.
PART II. LESSONS LEARNED
THE MAJOR SERVICE SECTORS
Scaling up family support is not an end in itself. It is, rather, a broad strategy for investing
in the next generation and thereby protecting and strengthening the nation. To succeed, the
endeavor must engage every sector of American society. With this in mind, the participants
at the Carnegie Corporation meeting undertook a sector-by-sector review of efforts to support
families, delineating lessons that may inform the process of going to scale. In the process, the
group posed two key questions: First, is it possible to take an existing delivery system and,
by adding or strengthening family-oriented services, convert it into an effective family support
and parenting education program? And second, is it possible to mesh the efforts of numerous
sectors into a network of services designed to strengthen families and build parental
competence?
Child Care
Most preschool children - by some estimates as many as 98 percent - are in out-of-home
child care at some point before they begin kindergarten. Because they have contact with so
many families, child care providers are ideally positioned to deliver a variety of family support
services. Child care providers may be based in schools, homes, health facilities, or community
institutions such as churches. Many of them, wherever they are based, share a commitment
to early prevention, a willingness to work with families, and an awareness of the
developmental stages of parenting. Some of the larger, better-designed child care programs,
such as Head Start, have strong parent involvement components. Many smaller programs and
providers also make efforts to support families, particularly through parent education. Some
see parent education as part of their mission from the start; others come to parent education
as a secondary focus.
For all of these reasons, meeting participants suggested that child care, as a service
sector, should be a strong contributor to the process of scaling up family support. A number
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of organizations are making active efforts to infuse family support principles into early care
and education projects. For example, the Parent Services Project, which seeks to strengthen
child care providers' capacity to support parents and families, has attracted both government
and foundation funding and is now functioning at more than one hundred sites around the
nation.
These efforts are encouraging. Without additional support and resources, however, few
child care providers today are in a position to take on new challenges. As Starting Points
documented, the vast majority of existing preschool programs provide substandard care and
lack the funding they need to improve quality. Most cannot hire enough adults in proportion
to the children in their care or pay salaries higher enough to attract or retain highly qualified
teachers or administrators. Until these hurdles are overcome, child care cannot fulfill its
promise as a key provider of family support services.
School-based Programs
Parent education is a process by which one generation transmits values and cultural patterns
to another. It begins long before prospective parents make their first prenatal visit. For this
reason, schools can play a key role in preparing young people to become good parents. Many
Americans are convinced that government, through its schools, should not be in the business
of promoting a particular set of values, mores, or lifestyles, and that other institutions, such
as faith institutions or community-based organizations, should have more influence in this
effort.
Nevertheless, because families tend to be smaller and more isolated than in past decades,
and because family life is more pressured, many parents welcome the role that public
institutions are playing in parent education, which in public schools is often called "family
life education." While a vocal group of conservative parents vigorously opposes family life
education, the majority of parents - according to one survey as many as 75 percent - say that
they support this trend.2⁸
Parents are not alone. Most state agencies and professional organizations also embrace
the notion that children and adolescents should receive age-appropriate family life education
and education for parenting. Despite their support, there has been little systematic research
on school-based preparation for parenthood. Its prevalence can be described only in the
broadest terms: forty-seven states have laws or policies that mandate or recommend some level
15
of family life or human sexuality education between kindergarten and grade twelve. Of these
states, thirty-nine have developed general curriculum guidelines. Few are comprehensive in
their coverage of key topics.²⁹
Even so, young people manage to receive little education for parenthood in the public
schools. Usually, the topic of parenting is presented only briefly, and only to the upper
grades. There are relatively few comprehensive, developmentally oriented family life education
programs. Where they do exist, scaling them up has proven difficult because of fiscal
constraints as well as political opposition. Moreover, there is little consensus on the content
of such programs, and most states leave the specifics up to local school districts and
communities. Meeting participants commented that standards, where they have been written,
tend to be too prescriptive; they may institute a one-size-fits-all approach that cannot
sufficiently accommodate cultural variation or reflect a community's wide spectrum of attitudes
and values. Schools may be able to avoid this pitfall by working in close partnership with
community-based organizations as they design and implement parenting education initiatives.
Some participants at the Carnegie Corporation meeting predicted that family life
curricula would be better accepted if they were redesigned as solidly academic courses in
human development or life sciences. In this form, they are less likely to be offered as electives,
sacrificed to "back-to-basics" movements, or eliminated as "frills" when budgets are cut. Others
observed that programs like family life or human sexuality or even health education remain
on the margins of the school curriculum because schools do not test for them. Still others
pointed out that parenting education curricula will not be widespread in schools until teachers
are given focused, specific preparation to teach them, both in schools of education and in-
service programs.
Many educators argue against a stand-alone parenting education curriculum, urging an
approach that imbeds preparation for effective parenthood into the overall pursuit of
dispositions and behaviors that are desired for children. They say that parent education should
not only be built into the formal curriculum; it should be infused as well into extracurricular
activities and, indeed, into the ethos of the school itself.
Public schools may also play a role in the provision of family support services. They
are, after all, common to every community and can often play a crucial role in bringing
together all of the community's stakeholders. In some cases, school buildings are serving as
16
community centers; in other cases, schools are adopting the "full-service school" model.³⁰ The
schools do not provide the services, but they share facilities with other agencies and
community-based organizations and become a hub of services. A case in point is the Caring
Communities Project in Missouri, which uses the school as the hub of a network for child care
providers. The program has been well accepted. It has used the rhetoric of shrinking
government and community-based decision making and ownership as the rationale for
wrapping services around the school.
Welfare
The 1990s appear to be an opportune time for bold efforts in welfare. Welfare reform has been
hoisted high on the national agenda and is likely to remain a critical social and economic issue
in the years to come. Because the status of the nation's children should be more central to the
welfare reform debate, any consideration of family support must take this issue into account.
According to one meeting participant, who is a government official steeped in the welfare
debate, focus groups held around the country indicate a widespread belief that welfare reform
efforts should focus on small children.
Missouri is an interesting case in point. The Missouri child welfare system provides
parent education, mandating it for those parents in the child welfare system who have a
confirmed history of abusing or neglecting their children. At the same time, Missouri offers
many other parents a strong incentive to participate in parent education on a voluntary basis.
It is the only state where involvement in the Parents As Teachers program counts toward the
twenty hours per week of work required to maintain one's standing in welfare.
Health
As a sector, health care is a very promising delivery system for family support and parent
education and can be a vital contributor to any effort to scale up support for parents. It is,
after all, an entry point for services or help. Of the 4 million births that take place each year
in this nation, the vast majority occur in hospitals or at least in the presence of medical
personnel. Moreover, good well-baby care includes periodic visits that provide an opportunity
to expand parent education and support. Another strength of the health care system is the
therapeutic alliance - a trusting relationship between provider and patient. Finally, the
expansion of the health care system and the extension of its role to include counseling parents
may be more palatable politically than the expansion of other kinds of services.
17
These are the pluses. At the same time, there are several factors that may limit the
effectiveness of the health care system in providing family support. The growth of managed
care and the pressure to contain costs have led to the rapid discharge of new mothers,
sometimes within twenty-four hours of giving birth. As a result, an important opportunity
is lost to work with parents at a critical time. The same forces have put pressure on
pediatricians to move patients through their office at a rapid rate, leaving many questions
unanswered and many anxieties unrelieved. There are fewer public health nurses to make
home visits to newborns and provide support to parents. And finally, the fragmentation of
health services means that a mother's health problems - including stress or depression - may
not be treated, even though she takes her child for regular well-baby visits.
The key to scaling up family support, from the viewpoint of health care, is to change
incentives in the system so that managed care organizations, such as health maintenance
organizations (HMOs), are rewarded for taking on a broader role in relation to families. Since
parents value expanded service, it may well prove to be a marketing advantage for these
organizations. Over time, the routine provision of parent education and family support may
be viewed as a strategy that is in the financial interests of health care providers. A first step
is for these organizations to determine which support services that parents really want. Once
this is established, health care providers must become more knowledgeable about these services
or be able to make appropriate referrals. They must ensure that their personnel, including
physicians, have the training they need to support and educate parents.
One innovative effort to infuse parent education into health care delivery has been
supported by the New York-based Commonwealth Fund. Known as Healthy Steps for Young
Children, this project integrates a parent education component into the basic package of
services provided by hospitals and HMOs to families with new children. Healthy Steps seeks
to expand pediatric primary care to include information on child development and guidance
and support for parents beginning in the late prenatal period and continuing through the first
three years of life. The project plans to pilot fifteen or more local initiatives, each a multiyear
partnership of the Commonwealth Fund, a local funder, and a local health care provider.
Criminal Justice
Of the 80,000 women incarcerated in the nation's jails and prisons, 76 percent have at least
two children. Most were the primary caregivers of their minor children before their
incarceration. Many inmates will resume their parenting responsibilities when they are
18
released from custody, but they will do so under very trying circumstances. Most incarcerated
mothers see their children infrequently and in stressful settings. (Male inmates tend to have
more frequent contact with their children, because the children's mothers are more likely to
arrange visits.) Not only the parents, but also the children, suffer from these constraints.
Approximately 1.5 million children have at least one parent who is in prison. Studies have
documented the traumatic effects on children of their parents' incarceration. Children of
prisoners are five to six times more likely than their peers to become incarcerated later in their
lives.³¹
In some places, the criminal justice system has taken up the challenge of providing
family support and parent education to inmates and their children. The oldest such program
functions at the Bedford Hills, New York, Women's Correctional Facility, which has
established a nursery for mothers who give birth while incarcerated, a parenting center, and
a children's center for visitors. Bedford Hills also offers a variety of parent education courses
taught by qualified inmates. Other correctional facilities across the nation are beginning to
create policies and programs that maintain contact between inmates and families, build parental
competence, and facilitate family interaction through structured visiting (including extended
visits with children). These efforts are only beginning, however.
MAINSTREAM INSTITUTIONS
Faith Institutions
Faith institutions are among the only places in the nation where more than one generation gets
together at the same time on a regular basis, providing a natural setting for parent education
and family support. From a historical viewpoint, faith institutions are uniquely positioned to
play a key role in the effort to scale up successful parent education and family support
initiatives.
Until the early twentieth century, churches were the major and sometimes the only
institution in the nation that responded to the needs of children, especially those in crisis.
Today, with the exception of public schools, congregations serve more children, youth, and
families than any other institution in our nation. Many have developed family ministries,
equipping lay church members to provide needed family support services, providing self-help
support, and offering professional family counseling. While faith organizations usually have
physical space and numerous volunteers, they are often strapped for funds. Many of these
organizations are competing for smaller and smaller pools of money. Some communities that
19
lack the resources to support their own parishioners are beginning to tap wealthier
congregations, seeking aid or sponsorship.
Recent changes in the church-going habits of many Protestants affect the churches'
capacity to provide family support. Today's families look for churches where they will feel
comfortable; they do not necessarily seek the denomination connected with their own
upbringing. The fastest-growing churches may have no affiliation with a national church body
or office. As a result, multiple strategies are needed to reach a large number of congregations
efficiently. Good candidates for community planning efforts are interfaith and ecumenical
coalitions. They often operate somewhat like a nonprofit but act as an umbrella group
representing a number of churches. They sometimes also operate direct service programs -
often with great efficiency.
Historically, predominantly black churches have grounded their family support efforts
within families and within communities. Until recent decades, predominantly white churches,
in contrast, have tended to care for needy children by removing them from the family and
community and placing them in residential homes, orphanages, and foster care. Today, black
churches remain very active in providing family support and offer huge potential for helping
to scale up community-based services.
Nationwide there are at least 75,000 black churches, serving more than 24 million
churchgoers. Many of these congregations reinforced their traditional community outreach
role in the 1980s as funding for social programs for minorities and the poor dried up. A recent
study known as the Black Church Family Project studied a representative sample of 635 black
churches and found that two-thirds of them had at least one community outreach program.
More than half of these programs address the needs of the family unit.³²
Increasingly, black churches are being asked to anchor services to communities that are
in transition. The churches have, to some degree, been responding to these problems and
appear to be a ready instrument for immediate transfer from public services to private
community-based services. Crucial infrastructure questions must be addressed, however. When
a religious community becomes a major provider, the dollar resources are often reduced and
issues of quality and evaluation are given short shrift.
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Funding is not the only issue. There are many churches, particularly smaller ones, that
are very community oriented and would be ready and willing to offer family support, but they
do not know how to do it. If they are to play a role in scaling up family support, faith
institutions of all kinds need help to build capacity.
Business
The corporate sector's involvement in parent education and family support is a recent
phenomenon that has grown out of employers' efforts to help employees arrange for child
care. A survey conducted in 1982, for example, found that 600 companies nationwide
provided employer-supported child care; by 1990, the number had grown to 5,600 companies.
Human resource executives say that the top three reasons for providing family support services
are employee morale, recruitment, and retention.³³
Today, the case is growing stronger for helping employees balance their work and
family life. Research by companies like IBM and Johnson & Johnson has found that these
supports result in a direct, measurable benefit to businesses. Businesses are building a portfolio
of success stories. There are many model programs and examples of businesses' successful
community investment projects. Indeed, companies are competing with each other to excel
in this area. One chief executive officer was recently asked what he would say to a peer who
resisted the idea of family support. He answered: "I'd hope he was a competitor and then I'd
keep my mouth shut."
Corporations are beginning to engage consultants to advise them specifically on family
and workplace issues. This is consistent with the trend toward outsourcing many human
resource functions. Some of these consultants began as child care resource and referral agencies
- the main concern of business ten years ago - and then developed a much broader focus,
helping corporations create more family-friendly policies and environments and change their
business culture to introduce the flexibility needed by working parents. Numerous companies
have asked consultants to help them integrate into their employee benefit packages a range of
family support services, such as prenatal classes, parenting seminars, and hotlines. Many
corporations also offer referral services, but a few are concluding that it is not enough to refer
employees to care in the community, because there may not be enough care, or the quality of
care may not be good enough. These companies have begun making investments in the long-
term process of building the supply and increasing the quality of local services.
21
These trends are encouraging, but meeting participants emphasized that family support
is by no means universal in the business community. Large companies tend to address family
concerns, but many employers remain relatively unresponsive to parents' problems or needs.
Moreover, in this period of corporate downsizing, the contingent workforce, made up of
employees who do not receive benefits of any kind, is growing. It is now 38 percent of the
workforce and is expected to grow to about 43 percent. These workers have little access to
employer-sponsored family support services.
The bottom line is that businesses have made strides over the last decade toward family-
friendly policies, but they have a long way to go. A recent study by the Families and Work
Institute found that most companies now provide maternity leaves and offer parents flexible
work schedules, such as part-time schedules or flextime. Only 28 percent offer child care
leaves for mothers, however, and only 13 percent sponsor on-site child care centers. The
steepest obstacle to change appears to be concern about cost and equity. Many corporate
decision makers continue to view family support as a "frill" that has no place in today's tough
environment, where only lean-and-mean companies can compete successfully. They are also
concerned about the problem of offering benefits only to one segment of their workforce.
They fear that if they provide support and education to parents with young children, they will
be forced to offer equivalent benefits to other employees as well, such as those with ailing
parents or troubled adolescents.
The Media
Parenting skills and information are no longer passed between generations or over backyard
fences as readily as they once were. Americans are therefore looking to the media to provide
parenting know-how, as they do for information about so many aspects of life.
In recent years there has been a marked increase in the publication of handbooks for
parents. Of the hundreds of books and publications on parenting available at any given
moment in bookstores and libraries, most address new parents. Periodicals with large
circulations, such as Parents Magazine, with a circulation of nearly 2 million a month, not only
offer advice to new mothers and fathers but also have the capacity to generate research by
surveying their readers.
At the same time, newsrooms are undergoing great change, driven by financial pressures
and declining readerships, and are looking for consumer relevancy and community
22
connections. One result is the development of civic journalism. There are new models of
reporting on children all around the country, and full-time "children's beats" are enjoying a
marked increase. A recent study of sixty-one newspapers and news services by the Casey
Journalism Center found that more than half have added children's and/or family beats in the
last three years. The news media today are devoting more space and resources than ever before
to this beat, offering "news-you-can-use" for parents and stories that search for explanations
of the forces in society that imperil children and families.
The electronic media can also play a role in strengthening parent education. Videotapes
hold great promise for parenting education, since four out of five American homes have a VCR,
and high-speed tape duplication has made it economically feasible to think of videotapes as
give-aways. A case in point: McDonalds and the New York City Department of Mental
Health have produced a videotape aimed at reaching at-risk adolescent parents with
information and messages geared to preventing abuse. Commercial talk radio is another
potentially powerful outlet for parenting education, and it has the advantage of being
interactive.
Meeting participants identified a number of gaps that the media need to close. Stories
on parenting tend to focus on young children; parents of adolescents receive far less attention,
information, and support. Television and radio coverage of parenting issues could be more
consistent. Child development specialists often make guest appearances on TV and radio, but
at present there is no national talk show that focuses on child development and parenting.
And finally, media critics note that both print and electronic media need to broaden their
concept of parenthood to include fathers more consistently.
GOVERNMENT
Federal Government
Federal initiatives in the realm of family support and family preservation have generally been
pursued within the framework of education, welfare reform, child care, and youth programs.
There have been some recent efforts to strengthen services to families with young children,
notably the Even Start Program, the introduction of Early Head Start as part of the Head Start
reauthorization bill, and the 1993 Family Preservation and Family Support Act.
The current political climate dictates against dramatic federal efforts in the realm of
education. Today, major federal initiatives in education are unlikely to succeed unless they are
23
voluntary, amenable to considerable flexibility, and based on local- and state-driven solutions.
They also need to be comprehensive, with family involvement in learning as part of a broad
set of comprehensive solutions. They need to allow states and communities that have bold
action plans to seek waivers to decategorize education programs, allowing a more
comprehensive approach.
Despite clear limitations, the federal government can be a catalyst for change by
supporting, modeling, linking, and assessing efforts to provide family support. In particular,
it can support a "visioning" process; fund research; facilitate and support collaboration; describe
and ensure equity; and offer training, technical assistance, and leadership development.
State Governments
The impetus for expanding family support over the last decade has occurred, for the most part,
at the local and state levels. As a result, many states have continued to take innovative
approaches to family support issues. Some have created programs that establish stand-alone,
community-based family resource centers and/or home visiting programs; others have built
family support initiatives into efforts to reform the educational, welfare, and public health
systems. Family support principles - including an emphasis on family-centered, preventive,
comprehensive, community-based services - have also been built into state authorizations for
existing programs operated by numerous state agencies. All of these actions reflect the
growing recognition by state policymakers that their constituents are worried about the severe
stress experienced by many families and want state government to respond with services that
are accessible, effective, and closely connected to the actual needs and strengths of families and
communities.
Meeting participants observed that, in order to expand family support, state
governments need to be active in five areas:
1) Providing leadership. State governments must create a vision that leads to a strategic
planning process, providing incentives, standards, and supports and sustaining commitment to
ongoing initiatives despite changes in administration. The state can create an environment
for innovation by partnering with other sectors, including the private nonprofit sector, the
corporate sector, and local government.
2) Establishing a policy framework. State agencies can often succeed by taking a single,
relatively simple concept and then making a sustained, systematic effort to build around it.
24
Vermont has done this, for example, with Success by Six, which wraps its family support
efforts around a home visiting program. As they develop policies and programs, states need
to make a commitment to going to scale, using cross-system approaches that take into account
all the services provided in the state, not just those identified as family support programs.
3) Ensuring an adequate and stable funding base. States must analyze and publicize areas
in which current investments are not paying off; increase investments overall, including
through the creative use of federal dollars; look for opportunities to invest in prevention; and
demonstrate that government can make responsible choices.
4) Developing partnerships at the local level. States provide a lawful structure for local
efforts. At the same time, they must build relationships with local government, including
school districts and neighborhood organizations. By offering reinforcement and public
approbation to promising local initiatives, states can make it possible for best practices to go
to scale.
5) Assuring quality. Today, many states are introducing or reinforcing a results-based
approach to program planning and implementation. But in setting standards, states must also
provide the assistance that local agencies and organizations need to meet those standards. Local
initiatives need information and assistance with planning, training, financing, evaluation, and
the use of electronic tools to coordinate efforts.
Local Governments
There is growing consensus among policymakers and taxpayers alike that grass-roots,
community-based human services make more sense than categorical programs, with their top-
down planning. It is recognized that, to function effectively, family support programs require
substantial planning at the local level where the families who need the services will access them
and use them. And yet, as things now stand, three out of four American cities have no formal
written policies or plans for services to families.34
Local governments bring numerous advantages to the task of establishing or expanding
family support services. They are often better able than other sectors to come up with flexible
initiatives that respond to emerging needs, and they are usually better positioned to take risks
with funding and program development. They can form partnerships with local businesses,
school districts, charitable organizations, and nonprofit organizations. They can act as role
models and test new initiatives by piloting programs for their own employees. Finally, local
governments are in a good position to build family support principles into local economic
development strategies.³⁵
25
In more and more communities around the nation, both elected officials and private
citizens are recognizing the link between the well-being of families and the vitality of the town
or city or county as a whole. In particular, they are realizing that when families fail or flee,
a community's economic prospects plummet. And yet, faced with severe fiscal constraints,
many policymakers are reluctant to launch new family support initiatives.
But even financially pressed communities can strengthen family support by reviewing
the existing services delivered by a wide variety of local government agencies and finding ways
within those systems to better serve families. They can devise strategies for building the kinds
of relationships among existing institutions and agencies, such as schools, libraries, health
services, police forces, and recreation departments, that will support the healthy development
of all of their children. They may want to start by evaluating the "family friendliness" of
current policies and practices, with a view toward strengthening those that make the locality
a good place for families to live and eliminating those that do not. In some cases, relatively
simple changes can make a big difference, such as shifting the hours when agencies are open
to match the realities of families' lives.
This kind of appraisal is certainly doable and can lead to a more comprehensive
assessment of the needs of children and families if there are individuals and organizations
prepared to carry it out. If not, then expanding family support requires a long-term
commitment to developing leadership and to building, over time, a broad community coalition
- in short, a constituency for change that comes together around a shared vision. The vision
may be broad, based on a collaborative process that allows people to think together about how
families can be better served, especially those with the greatest need. But it should also stress,
at least at first, a single critical issue (prenatal care, or immunization, or affordable child care)
that can help to focus community interest and activism.
The process of elaborating a vision should lead to a plan for cooperation across levels
and departments. The plan should establish benchmarks, stating precisely what the
community wants to achieve and how it can measure success. The plan may involve
identifying, expanding, and linking effective community programs; it may call for innovation.
In any case, it should identify every possible source of funds and other resources for family
support projects - not only government sources, but also the philanthropic and business
communities. Finally, the plan should encompass evaluation. An independent monitoring
26
process helps to ensure that a community's policies and practices - both old and new - move
it toward the results defined during the visioning process.
PART III. GOING TO SCALE
DEFINING "SCALING UP"
Today there are thousands of scattered initiatives across the nation aimed at strengthening
parental competence and helping young families thrive. A multitude of parent education
programs operate under many guises. Scaling up these efforts does not only mean showcasing,
evaluating, and expanding effective initiatives; it means reaching a population that is large
enough to allow testing of the program's capacity to improve results on a systemwide basis;
and also implementing the program in a sufficiently large jurisdiction to test it in a variety of
settings, where diverse obstacles will be encountered.36 Ultimately, scaling up involves creating
the infrastructure for nationwide high-quality services for families and building a professional
field of effective initiatives that are nailed into policy and resources.
In a fully scaled-up system of supportive services, the vast majority of people who need
services and are eligible to receive them would be reached. As one meeting participant noted,
even 96 percent penetration does not suffice if the 4 percent who are not served represent a
particular group that has demonstrable need. A long-range plan therefore should, over time,
move the nation toward the goal of making services available to every family that wants to
take advantage of them.
Many sectors of the society and as many organizations and individuals as possible must
be engaged on behalf of parents and their young children - a process that may involve the
shifting down of responsibility from a central (federal or state) authority to local community
groups. Because federal and state governments have historically played a strong role in
assuring equity, this complex transfer of power may jeopardize the rights of disadvantaged or
marginalized populations. This is not the inevitable outcome, however. States that are now
in the process of scaling up parent support, like Missouri and Vermont, appear to be taking
this danger into account and are building slowly with considerable attention to what happens
to equity as devolution proceeds.
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CREATING SYSTEMS OF SERVICES
Family support may be seen as both the provision of information and supports to families
with young children and the creation of systems of services that enable families to get the help
they need to raise their children. To be responsive to children and their parents, services must
be linked because families' needs and strengths do not come in neat packages. Policymakers
are beginning to recognize that effective parenting education and family support must be
comprehensive in purpose. They are beginning to think about family support programs,
including parenting education efforts, as part of broader efforts to reconfigure systems of
service.
The challenge of "going to scale" raises a crucial issue: Is the priority to scale up
family support as a set of discrete programs? Or should policymakers be working toward
scaling up family support in the context of efforts to build a comprehensive system of services?
Is it feasible in practice to start categorical and then build programs into systems?
Recent experience suggests that it is reasonable to start by scaling up successful
programs. All of the states that have launched ambitious family support initiatives began by
creating discrete programs within a particular system, usually education or social services. In
each instance, the initiative is now "moving out"- that is, taking its place as part of broader,
cross-agency efforts to support families and reform delivery systems.
SCALING UP PARTICIPATION
The challenge, broadly stated, is to rebuild communities so that supports are in place to meet
the needs of children and families and to make or revise policy at the state and federal level
to facilitate that process. For this to happen, family support principles must be infused into
mainstream agencies and organizations at every level. They must be communicated in ways
that will make sense to large numbers of people who may not be acquainted with them.37
As part of that process, policymakers must address the question of whether family
support and parent education services should be provided on a universal basis, or targeted to
particular populations. This issue sparks heated debate, even within the family support
movement. Historically, categorical approaches have often reached dead ends.
Some researchers, practitioners, and policymakers argue for universal programs, with
different supports for different kinds of families, based on indicators showing that virtually all
28
families are under stress. A concern is that targeted family support echoes the biases of the
charity organization movement of a century ago, by reflecting the assumption that poor
people, people of color, and immigrants need parenting education in order to absorb the
values, practices, and lifestyles of the dominant culture. Finally, supporters of universal services
cite political considerations: many legislators are on record that they will only vote for
universal programs that benefit all of their constituents.
Proponents of targeted services, on the other hand, argue for political realism. They
assert that, in an era of scarce resources, services should be directed to the families and children
who need them most - poor children and those demonstrably at risk of developmental delays,
health problems, and school failure. They observe that the argument for universal services
may not survive massive taxpayer resistance to increased social spending. As one participant
commented, "Today the alternative to doing everything for everybody may be to do nothing
for anybody."
Finally, they note that the case for universal services rests on the premise that all
parents and their children stand to benefit from access to family support services, particularly
if those services are designed to meet parents' needs as they themselves define them. Existing
evaluations have not, however, been able to demonstrate conclusively the benefits of family
support interventions for middle-class families.³⁸ This may reflect flaws in the evaluation
design, rather than program weakness. In any case, the universal argument cannot be made
persuasively until more evidence is gathered. The need for evaluation is not limited to the
benefits for middle-class parents. In general, policymakers need more solid information on the
impact of parent education and family support initiatives on various populations.
SCALING UP EVALUATION
Most evaluations of family support programs have been limited to a short time span - three
to five years at most. To understand the impact of family support over time, the obstacles to
change, and the kinds of programs that can overcome those obstacles, more long-term studies
are needed.
There is a need to know whether programs designed for families with young children
are likely to have a sustained effect on those children, including their own ability to be
effective parents two or three decades later. Understandably, most politicians and the public
are unwilling to wait twenty years to test a program's impact. And given today's budget
29
constraints, it is very difficult to secure funding for very long-term studies. As a result, big-
picture evaluations may not be viable at the present time.
It is possible to document more fully and more effectively a range of indicators that
shed light on the impact of family support. These data can help to shape new legislative and
programmatic initiatives. Some researchers argue for "reinventing evaluation" - devising
innovative knowledge development strategies that can help policymakers drive change and can
give local communities the capacity they need to pursue effective, cost-effective strategies.
Rather than asking whether family support works, researchers need to ask: What works best
for whom?³⁹
LESSONS LEARNED FROM CURRENT EFFORTS
While continued research and evaluation efforts will help policymakers and practitioners target
resources and improve results, enough is known about family support to counter the
widespread perception that nothing works when it comes to improving the prospects for vast
numbers of at-risk children. Indeed, the task of scaling up family support is already in
progress in a number of states, including Maryland, Minnesota, Missouri, Kentucky, Tennessee,
and Vermont, and in many communities. From these, a number of crucial lessons about the
process have been learned:
1) Scaling up high-quality programs in any significant way requires enormous investments
of time, energy, and resources. An urgent priority is the creation of an infrastructure that
strengthens and coordinates funding, training, quality control, and evaluation.
2) The federal government must not relinquish its stake in family support. States and local
communities need assistance as they think through the best ways to approach complex infrastructure
issues. In particular, family support and parent education require a broad perspective on training,
capacity building, and evaluation.
3) It is impossible to overstate the critical importance of leadership and political skill,
particularly the ability to read what will motivate policymakers and build political will. The
political entrepreneurs who have successfully brought programs to scale have been attuned to the
kinds of program design and strategy that would make their initiatives politically marketable
within their states. It is essential to tailor advocacy for these kinds of programs to local political
circumstances, and to fit them into the local political agenda.
30
4) Most states that are scaling up programs have been able to sell, to their legislatures and
their state agencies, the notion that family support is a great way to invest in the future, to promote
the human capital, and to contain escalating social spending.
5) All of the states that are successfully scaling up family support have dealt with volatile
intrusion-into-family issues by ensuring a balance of power between localities and states. None has
left itself open to the charge that the state is dictating to local people how they should raise their
children.
6) Additional research is needed to support the process of planning, implementing, and
scaling up high-quality programs.⁴⁰
FOCUS ON QUALITY
The 1980s and 1990s have witnessed great progress in the field of family support and parent
education. Concepts that once met wide resistance are now widely embraced by policymakers
and service providers alike. It is now common wisdom in many quarters that, if the prospects
for children are to be enhanced, the focus has to be on at least two and maybe three
generations - on parents and children and grandparents. It is now widely accepted that
parents, to succeed, need communities, not just a service or even a couple of services but a set
of connections that encompass both the public and private sectors.
But these principles, even when they are reflected in planning efforts, mission
statements, and pilot projects, do not always translate into policies or practices that support
and preserve families.41 In fact, in a recent international study, the United States ranked in the
lower half of Western industrialized countries in providing family support services.⁴² This
country is not yet close to systematizing any effort toward comprehensive family support or
parent education. Investments to preserve families remain small.43 And generally speaking,
strengthening families remains low on the nationwide public policy agenda.
The challenges are practical as well as political. Today, services to families and
children, particularly those financed and regulated by the states, remain largely categorical and
fragmented - a patchwork pieced together from the education, health, child welfare, juvenile
justice, and mental health systems. Generally speaking, the fragmented, mainstream service
system does not yet embrace family support principles; those services that do embody family
support principles tend to be add-ons to this mainstream service system. Moreover, the most
31
vulnerable families and the most troubled young people tend to be served by the more
categorical and traditional service systems. Despite rhetoric about family preservation, recent
years have seen an increase in out-of-home placements of children into foster care, mental
health facilities, and juvenile detention and training schools.44
Good practice exists at thousands of family centers and parent support programs across
the country, as well as in agencies and schools that embrace family support principles. But at
this point, family support lacks clear-cut quality standards for program content, performance,
and delivery. Articulating and codifying these standards is an extremely difficult task, because
family support is, by definition, a multifaceted effort that seeks results in several domains at
once: children, family, programs, communities, normative public agencies, and service delivery
systems.45
Efforts are now under way to define and implement quality standards. For example, in
1992 the Family Resource Coalition launched the Best Practices Project, an effort to specify
standards of quality based on the most effective practices of existing community-based family
support programs. This effort mines the knowledge and experience of leading researchers and
practitioners, as well as focus groups, and will digest its findings into user-friendly guidelines
for excellent practice in the field of family support.46 Over the next decade, the challenge is
to follow up on this and other efforts to define quality, by systematically infusing best
practices into new policies and the programs they generate, so that, as a nation, the United
States can move toward high-quality, integrated systems of family support and parent
education.
#
32
ENDNOTES
1. U.S. Bureau of the Census, Economics and Statistics Administration, Statistical Abstract
of the United States, 1994, 114th ed. (U.S. Department of Commerce, 1994).
2. Craig T. Ramey and Sharon Landesman Ramey, "Home Visiting Programs and the
Health and Development of Young Children," The Future of Children, vol. 3, no. 3 (Winter
1993).
3. Sharon L. Kagan and Nancy Cohen, Report of the Quality 2000 Initiative (New Haven:
The Bush Center in Child Development and Social Policy at Yale University,
forthcoming).
4. U.S. Bureau of the Census, Statistical Abstract of the United States, 1994.
5. K. J. Pittman with M. Wright, A Rationale for Enhancing the Role of the Non-School
Voluntary Sector in Youth Development, report prepared for The Carnegie Council on
Adolescent Development Task Force on Youth Development and Community Programs
(Washington, D.C.: Center for Youth Development and Policy Research, Academy for
Educational Development, 1991).
6. U.S. Bureau of the Census, Statistical Abstract of the United States, 1994.
7. Jeanne E. Griffith, The Children of Teenage Mothers, report no. 87-94 EPW (Congressional
Research Service, 1987).
8. Families and Work Institute, Employers, Families, and Education: Facilitating Family
Involvement in Learning (New York, 1994).
9. Sharon L. Kagan, Defining America's Commitments to Parents and Families: An
Historical-Conceptual Perspective (April 1994).
10. Sarah S. Brown, "Preparation for Parenthood," in The Challenge of Parenting in the
Nineties (Washington, D.C.: The Aspen Institute, 1995)
11. Kagan and Cohen, Report of the Quality 2000 Initiative.
12. Arloc Sherman, Wasting America's Future: The Children's Defense Fund Report on the
Costs of Child Poverty (Boston: Beacon Press, 1994).
13. Heather B. Weiss, "Building Villages: Lessons from Policy Entrepreneurs," in Visions of
Entitlement, The Care and Education of America's Children, ed. Mary A. Jensen and Stacie
G. Goffin (Purchase, N.Y.: State University of New York, 1993).
14. Frank Farrow, "Family Support on the Federal Policy Agenda," in Putting Families
First: America's Family Support Movement and the Challenge of Change, ed. Sharon L. Kagan
and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
33
15. Kagan and Cohen, Report of the Quality 2000 Initiative.
16. Heather B. Weiss, "Home Visits: Necessary But Not Sufficient," The Future of Children,
vol. 3, no. 3 (Winter 1993).
17. David Olds, "Promising Preventive Interventions During Pregnancy, Infancy, and Early
Childhood," in The Challenge of Parenting in the Nineties (Washington, D.C.: The Aspen
Institute, 1995).
18. Ibid.
19. Ibid.
20. Ibid.
21. T. Kellaghan et al., "The Effectiveness of Family-Intervention Programs," in Home
Environment and School Learning: Promoting Parental Involvement in the Education of
Children (San Francisco, Ca.: Jossey-Bass, 1993).
22. Norm Fruchter, Anne Galletta, and J. Lynne White, "New Directions in Parent
Involvement," in Equity and Choice, vol. 9, no. 3 (1993).
23. Kagan, Defining America's Commitments to Parents and Families.
24. Fruchter, Galletta, and White, "New Directions in Parent Involvement."
25. Joy G. Dryfoos, Full-Service Schools: A Revolution in Health and Social Services For
Children, Youth, and Families (San Francisco, Ca.: Jossey-Bass, 1994).
26. Sharon L. Kagan, "On Building Parental Competence: The Nature of Contracts and
Commitments," in The Challenge of Parenting in the Nineties (Washington D.C.: The Aspen
Institute, 1995).
27. Robert I. Crowson and William Lowe Boyd, "Coordinated Services for Children:
Designing Arks for Storms and Seas Unknown," in American Journal of Education, vol. 101
(1993).
28. Kathryn Young, "Education for Parenting," paper presented to the Carnegie
Corporation of New York Conference on Scaling Up Family Support and Parent
Education (November 16-17, 1994).
29. Ibid.
30. Dryfoos, Full-Service Schools.
31. Ann Adalist-Estrin, "Family Support and Criminal Justice," in Putting Families First:
America's Family Support Movement and the Challenge of Change, ed. Sharon L. Kagan and
Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
34
32. Cleopatra Howard Caldwell, Angela Dungee Greene, and Andrew Billingsley, "Family
Support Programs in Black Churches: A New Look at Old Functions," in Putting Families
First: America's Family Support Movement and the Challenge of Change, ed. Sharon L. Kagan
and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
33. Families and Work Institute, "Comparative Analysis of Work-Family Programs in
Major Corporations," in The Corporate Reference Guide to Work Family Programs (New
York: Families and Work Institute, 1991).
34. National League of Cities cited in Norman B. Rice, "Local Initiatives in Support of
Families," in Putting Families First: America's Family Support Movement and the Challenge of
Change, ed. Sharon L. Kagan and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass,
1994).
35. Rice, "Local Initiatives in Support of Families."
36. Ibid.
37. Sharon L. Kagan, "Defining and Achieving Quality in Family Support," in Putting
Families First: America's Family Support Movement and the Challenge of Change, ed. Sharon
L. Kagan and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
38. Olds, "Promising Preventive Interventions During Pregnancy, Infancy, and Early
Childhood."
39. Kellaghan et al, "The Effectiveness of Family-Intervention Programs."
40. Weiss, "Building Villages: Lessons from Policy Entrepreneurs."
41. Charles Bruner, "State Government and Family Support: From Marginal to
Mainstream," in Putting Families First: America's Family Support Movement and the Challenge
of Change, ed. Sharon L. Kagan and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass,
1994).
42. Cited in Camille Sweeney, "Portrait of the American Child, 1995," The New York Times
Magazine (October 9, 1995).
43. Kagan, Defining America's Commitments to Parents and Families.
44. Bruner, "State Government and Family Support."
45. Kagan, "Defining and Achieving Quality in Family Support."
46. Ibid.
35
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Caldwell, Cleopatra Howard, Angela Dungee Greene, and Andrew Billingsley. "Family
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Crowson, Robert I., and William Lowe Boyd. "Coordinated Services for Children: Designing
Arks for Storms and Seas Unknown." American Journal of Education, vol. 101 (1993).
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Abuse Prevention." Journal of Interpersonal Violence, vol. 7, no. 4 (1992).
Dryfoos. Joy G. Full-Service Schools: A Revolution in Health and Social Services For Children,
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Families and Work Institute. "Comparative Analysis of Work-Family Programs in Major
Corporations." In The Corporate Reference Guide to Work Family Programs. New York:
Families and Work Institute, 1991.
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York: Families and Work Institute, 1994.
Farrow, Frank. "Family Support on the Federal Policy Agenda." In Putting Families First:
America's Family Support Movement and the Challenge of Change. Ed. Sharon L. Kagan and
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Bernice Weissbourd. San Francisco, Ca.: Jossey-Bass, 1994.
Fruchter, Norm, Anne Galletta, and J. Lynne White. "New Directions in Parent
Involvement." Equity and Choice, vol. 9, no. 3 (1993).
Galinsky, E. and Friedman. Education Before School: Investing In Quality Child Care. New
York: Families and Work Institute, 1993.
Greenawalt, C. E. II. "Educational Outreach Programs." In Educational Innovation: An
Agenda to Frame the Future, ed. C. E. Greenawalt. Lanham: University Press of America, 1994.
Griffith, Jeanne E. The Children of Teenage Mothers. Congressional Research Service, report no.
87-94 EPW, 1987.
Henderson, Anne T., and Nancy Berla. A New Generation of Evidence: The Family Is Critical
to Student Achievement, 1994.
Kagan, Sharon L. Defining America's Commitments to Parents and Families: An Historical-
Conceptual Perspective, April 1994.
"Defining and Achieving Quality in Family Support." In Putting Families First:
America's Family Support Movement and the Challenge of Change. Ed. Sharon L. Kagan and
Bernice Weissbourd. San Francisco, Ca.: Jossey-Bass, 1994.
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39
APPENDIX A
AGENDA
PARENT EDUCATION AND FAMILY SUPPORT: OPPORTUNITIES FOR SCALING UP
November 16-17, 1994
WEDNESDAY, NOVEMBER 16, 1994
PLACE:
Carnegie Corporation of New York
437 Madison Avenue
New York, New York 10022
12:00-1:00 p.m.
Lunch
1:00-1:30 p.m.
Welcome and Overview David A. Hamburg
2:00-2:30 p.m.
Parent Education and Family Support: Lessons from
Existing Initiatives - Heather Weiss
2:30-3:30 p.m.
Discussion
Moderator: David A. Hamburg
3:30-3:45 p.m.
Break
3:45-4:15 p.m.
Parent Education and Family Support: Illustrations from
Mainstream Institutions - Kathryn Taaffe Young
4:15-5:15 p.m.
Discussion
Moderator: David A. Hamburg
6:30-8:30 p.m.
Informal Gathering and Dinner
The New York Palace
The Library and Drawing Room ~ 3rd floor
THURSDAY, NOVEMBER 17, 1994
8:00-8:30 a.m.
Continental Breakfast
8:30-10:30 a.m.
Linking Parent Education and Family Support to the Service
Sectors
Moderator: Vivien Stewart
Child Care
- Lynn Kagan
Education
- Gordon Ambach
Health
- Karen Davis
Welfare
- Gary Stangler
Discussion
10:30-10:45 a.m.
Break
10:45 a.m.-12:30 p.m.
New Opportunities Within Mainstream Institutions
Moderator:
Kathryn Taaffe Young
Churches
- Reverend Carolyn Bullard-Zerweck
- Laura Dean Ford Friedrich
Media
- Larry Kutner
- Ann Pleshette-Murphy
Business
- Betty Southwick
- Deborah Stahl
Discussion
12:30-1:30 p.m.
Lunch
1:30-3:30 p.m.
The Role of Government
Moderator: Michael H. Levine
State
- Con Hogan
- Patrick McCarthy
Federal
- Olivia Golden
- Terry Peterson
Discussion
3:30-4:30 p.m.
Mapping Strategies for Scaling Up Parent Education and
Family Support
Moderator: Vivien Stewart
Judy Jones
4:30 p.m.
Meeting Adjourned
APPENDIX B
LIST OF PARTICIPANTS
Parent Education and Family Support: Opportunities for Scaling Up
November 16-17, 1994
1.
Karen Alexander, Ph.D.
Psychologist
Bush Center in Child Development and Social Policy
Yale University
New Haven, Connecticut
2.
Gordon Ambach
Executive Director, Council of Chief State School Officers
Washington, D.C.
3.
Karen Bell
Associate Director of Child and Family Health
National Center for Children in Poverty
Columbia University
New York, New York
4.
Leslie Mitchel Bond
Director, Healthy Families America
National Committee to Prevent Child Abuse
Chicago, Illinois
5.
The Reverend Carolyn Bullard-Zerweck
Program Associate for Witness and Service
Greater Dallas Community of Churches
Dallas, Texas
6.
Karen Davis, Ph.D.
Executive Vice President, The Commonwealth Fund
New York, New York
7.
Frank Farrow
Director, Children's Services Policy
Center for Study of Social Policy
Washington, D.C.
8.
Laura Dean F. Friedrich, M.Ed.
Director, Church/Community Consultation Services
CHILDSERV
Park Ridge, Illinois
9.
Ellen Galinsky
Co-President, Families and Work Institute
New York, New York
10.
Stacie Goffin, Ed.D.
Senior Specialist
Ewing Marion Kauffman Foundation
Kansas City, MO
11.
Olivia A. Golden, Ph.D., M.A.
Commissioner, Administration on Children, Youth, and Families
United States Department of Health and Human Services
Washington, D.C.
12.
Margaret A. Hamburg, M.D.
Commissioner of Health
New York City Department of Health
New York, New York
13.
Ruby P. Hearn, Ph.D.
Vice President, Robert Wood Johnson Foundation
Princeton, New Jersey
14.
Cornelius Hogan
Secretary, Agency of Human Services
Waterbury, Vermont
15.
Judith E. Jones
Chairperson, Council of Advisors
National Center for Children in Poverty
School of Public Health
Columbia University and
Director of the Free to Grow Program
New York, New York
16.
Sharon Lynn Kagan, Ed.D.
Senior Associate, Bush Center in Child Development
and Social Policy
Yale University
New Haven, Connecticut
17.
Herant Katchadourian, M.D.
Professor, Psychiatry and Behavioral Sciences
Program in Human Biology
Stanford University
Stanford, California
18.
Larry Kutner, Ph.D.
Journalist and Author
New York, New York
19.
Shawn LaFrance
Program Officer, The Commonwealth Fund
New York, New York
20.
Margaret E. Mahoney
President, The Commonwealth Fund
New York, New York
21.
Patrick McCarthy, Ph.D.
Senior Associate, Child and Adolescent Health
The Annie E. Casey Foundation
Baltimore, Maryland
22.
Ann Pleshette Murphy
Editor-in-Chief
Parent Magazine
New York, New York
23.
Barbara Peters
The Partnership Group
New York, New York
24.
Terry K. Peterson, Ph.D.
Counselor to the Secretary
United States Department of Education
Washington, D.C.
25.
Edward Pitt
Director, Male Involvement Project
Families and Work Institute
New York, New York
26.
Gloria G. Rodriguez, Ph.D.
President and Chief Executive Officer
Avance Family Support and Education Program
San Antonio, Texas
27.
Betty J. Southwick
Director of Progam Development
Work/Family Directions
Boston, Massachusetts
28.
Deborah Stahl
Director, Family Care Development Fund
AT&T
Morristown, New Jersey
29.
Gary Stangler
Director, Missouri Department of Social Services
Jefferson City, Missouri
30.
Layla P. Suleiman
Associate Director of Programs
Family Resource Center
Chicago, Illinois
31.
Cathy Trost
Director, The Casey Journalism Center for
Children and Families
College of Journalism
University of Maryland
College Park, Maryland
32.
Heather Weiss, Ed.D.
Director, Harvard Family Research Project
Graduate School of Education
Harvard University
Cambridge, Massachusetts
33.
Susan N. Wilson
Executive Director, Network for Family Life Education
Center for Social and Community Development
Rutgers University
New Brunswick, New Jersey
34.
Mildred M. Winter
Executive Director
Parents As Teachers National Center, Inc.
St. Louis, Missouri
~
Carnegie Corporation of New York Staff
1.
David A. Hamburg, President
2.
Barbara D. Finberg, Executive Vice President
and Program Chair, Special Projects Committee
3.
Vivien Stewart, Senior Advisor to the President and
Program Chair, Education and Healthy Develpment of Children and Youth
4.
Michael H. Levine, Program Officer
Education and Healthy Development of Children and Youth
5.
Gloria Primm Brown, Program Officer
Education and Healthy Development of Children and Youth
6.
Karin P. Egan, Program Officer
Education and Healthy Development of Children and Youth
7.
Anthony W. Jackson, Program Officer
Education and Healthy Development of Children and Youth
8.
Kathryn Taaffe Young, Director of Studies
Task Force on Meeting the Needs of Young Children
9.
Antony Ward, Executive Director
Task Force on Learning in the Primary Grades
10.
Fred M. Hechinger, Senior Advisor
11.
Susan V. Smith, Program Associate
Education and Healthy Development of Children and Youth
12.
Nidia Marti, Administrative Assistant
Education and Healthy Development of Children and Youth
13.
Bonnie J. Piller, Secretary
Task Force on Meeting the Needs of Young Children
14.
Kathleen Sheridan, Secretary
Education and Healthy Development of Children and Youth
~
Rapporteur
15.
Rima Shore
Brooklyn, New York
~
Meeting Reporter
16.
Victoria McLaughlin
Miller Reporting
the
FAMILY SUPPORT AND PARENT EDUCATION:
OPPORTUNITIES FOR SCALING UP
By Rima Shore
Report of a Meeting Convened
by Carnegie Corporation of New York
November 16-17, 1994
From time to time Carnegie Corporation supports
meetings on issues of importance that may or may not
be closely related to its grant programs. Occasionally,
reports of these meetings merit public dissemination.
CONTENTS
FOREWORD
i
INTRODUCTION
1
PART I. THE STATE OF THE ART
2
THE PROBLEM: A PATTERN OF NEGLECT
2
Meeting the Needs of Preschool Children
3
Concerns of Parents
4
Research on the Status of Children and Families
5
THE SOLUTION: BUILDING PARENTAL COMPETENCE
6
Local Efforts
6
State-sponsored Efforts
6
Federal Efforts
6
Types of Family Support Programs
7
Examples of Family Support Programs
9
IMPACT OF FAMILY SUPPORT AND PARENT EDUCATION: THE EVIDENCE
11
THE CHALLENGE: MOVING FROM PROGRAMMATIC TO SYSTEMIC EFFORTS 12
PART II. LESSONS LEARNED
14
THE MAJOR SERVICE SECTORS
14
Child Care
14
School-based Programs
15
Welfare
17
Health
17
Criminal Justice
18
MAINSTREAM INSTITUTIONS
19
Faith Institutions
19
Business
21
The Media
22
GOVERNMENT
23
Federal Government
23
State Governments
24
Local Governments
25
PART III. GOING TO SCALE
27
DEFINING "SCALING UP"
27
CREATING SYSTEMS OF SERVICES
28
SCALING UP PARTICIPATION
28
SCALING UP EVALUATION
29
LESSONS LEARNED FROM CURRENT EFFORTS
30
FOCUS ON QUALITY
31
ENDNOTES
33
REFERENCES
36
APPENDIX A: Agenda
APPENDIX B: List of Participants
FOREWORD
P
arenthood is a very big job - a huge investment of time, energy, and sustained attention
to childraising; and a great learning experience. But the process is far from simple - and
now it is more complicated than ever.
In the United States, the structure and function of families have undergone profound
changes in just the past thirty years. Some of these changes represent new opportunities and
tangible benefits. Others place the well-being of children in such jeopardy as to pose a
problem for the entire society. One striking change from the perspective of child development
is the widespread entry of mothers of preschool and school-age children into the paid
workforce - now reaching about 60 percent. Another change is the growth of teenage
parenthood. Although the birthrate for adolescents has leveled off, each year teenagers give
birth to nearly half a million babies. Yet another drastic change is the large number of
children growing up with only one parent; indeed, most American children today spend at
least part of their childhood in a single-parent family.
By and large, young people moving toward parenthood today are far less experienced
in the care of children than were their grandparents; they spend less time with their children
than previously; and a majority of parents report they are less willing than were their parents
to make key sacrifices for the next generation.
However much the American family has been transformed in the latter twentieth
century, it is still the fundamental unit responsible for the health, education, and general well-
being of children. Whatever has happened to it, the family is still the central organizing
principle of the society. But families do not function in isolation. To be successful, they need
an appropriate social environment - one that provides supportive social networks, a firm sense
of community, mutual aid, and a feeling of belonging.
In view of the drastic family dislocations of recent decades, the traditional sources of
family support have been seriously weakened. Increasingly, other institutions and
organizations of society are stepping in with programs to help prepare young people for
responsible parenthood, build parental competence, and strengthen the family through new
supportive systems. The potential of these programs to fill in the gaps and help meet the basic
needs of families and children is enormous. But they must become more widely available.
In November 1994, Carnegie Corporation drew together a group of experienced
professionals in the domains of parent education and family support to review the experience
of programs offered by schools, health care institutions, faith organizations, the private sector,
nonprofit organizations, and government to strengthen parents' ability to care for themselves
and their children and to consider the requirements for "scaling up."
We are most grateful for the participation of these experts over two days of intensive
discussion. We further thank Rima Shore for preparing this extremely fine report synthesizing
the proceedings and the relevant literature, and Michael Levine, program officer in the
Corporation's Children and Youth program, for overseeing the development of the report.
Kathryn Taaffe Young, senior program officer at Commonwealth Fund, played an important
role in organizing the conference. It is our hope that the report will stimulate serious thought
and practical action on ways to bring parent education and family support to all who need it.
David A. Hamburg, President
Carnegie Corporation of New York
ii
FAMILY SUPPORT AND PARENT EDUCATION:
OPPORTUNITIES FOR SCALING UP
By Rima Shore
Report of a Meeting Convened
by Carnegie Corporation of New York
November 16-17, 1994
M
ost Americans live and raise children in family units. In fact, the United States
population encompasses more than 67 million families with children under the age of
eighteen.¹ To be sure, these families vary in structure, size, and self-description. But to a great
extent people in every sector of American society are recognizing that the conditions and
experiences that most directly affect children's lives are embedded in the contexts of families.
Decision makers are acknowledging that if their policies are to address the urgent needs of
children, families must be systematically supported.²
Today, some of the resources traditionally available to young families - the kind of
help and skills shared among large extended families and close-knit communities - are no
longer within the reach of many Americans. A wide range of institutions and agencies, private
and public, have been working to fill the void. They now offer an array of services and
interventions designed to strengthen families and to impart the knowledge and skills that can
help parents fulfill their role with greater confidence and competence.
On November 16-17, 1994, Carnegie Corporation of New York convened a meeting
to discuss the lessons learned from existing initiatives and to examine strategies for scaling up
successful efforts. This meeting gathered individuals with expertise in some aspect of family
support or parent education: independent researchers, academics, government policymakers,
decision makers from the various service sectors, and leaders representing faith organizations,
the media, and business. This report compiles the ideas, facts, trends, conclusions, and
recommendations that emerged at the meeting, drawing as well on background documents and
relevant data.
Part I of this report outlines the case for strengthening families, provides a broad
overview of existing family support and parent education efforts, summarizes findings on the
effectiveness of these programs, and discusses the challenge of moving from programmatic to
more systemic efforts. Part II summarizes the lessons learned from existing initiatives in every
sector of American life, including the major service sectors (child care, education, health,
welfare, and criminal justice); mainstream institutions (faith institutions, business, and the
media); and government (federal, state, and local). Part III presents the challenges of going to
scale.
PART 1. THE STATE OF THE ART
THE PROBLEM: A PATTERN OF NEGLECT
The springboard for the discussion of scaling up family support programs was the 1994 report
issued by Carnegie Corporation of New York, Starting Points: Meeting the Needs of Our
Youngest Children. Starting Points presented the scientific evidence that has accumulated over
the last decade confirming what parents and teachers have long suspected - that children's
early care and environment have a decisive, lasting effect on their later development, including
not only their physical development but also their intellectual and emotional growth. It
documented a pattern of neglect that threatens the well-being of young children and of the
society they will inherit.
Starting Points found that when women and men are prepared for the opportunities
and responsibilities of parenthood, they are more likely to provide the care and create the
conditions that promote healthy development. It emphasized that the kinds of knowledge that
can help parents give their children a good start in life - knowledge about child development
and child health, for example - does not come naturally; nor is it always available from
relatives or neighbors. For this reason, virtually all parents can benefit from the kinds of
information and guidance that help them understand and respond to their children's physical,
intellectual, and emotional growth, particularly in the first three years of life when
development proceeds at such a dizzying pace. This finding is borne out by the fact that,
across the nation, families at all income levels and in all kinds of communities - urban,
suburban, and rural - are taking advantage of existing family support services.³
2
Meeting the Needs of Preschool Children
While parents of school-age children can certainly profit from family support, parents of
infants and toddlers may benefit the most. And since the number of children under age five
has increased sharply in recent years, rising by 18.6 percent from 1980 to 1993, more and more
parents are struggling to meet preschoolers' needs.4 At times, those needs seem relentless.
Compared to the young of other species, human children are remarkably helpless. The very
survival of the human species therefore hinges on adequate parenting throughout an extended
childhood (although parents who are trying to comfort a wailing newborn at three A.M. or
reason with a thrashing three-year-old who will not get into her car seat may have more
doubts about their own survival than that of their child).
And yet, parents must do much more than safeguard their children's (and their own)
physical health and safety; they must also provide for their emotional, intellectual, social, and
spiritual development and well-being. As their children grow, parents must continue to
provide a sense of safety and structure, belonging, self-esteem and self-reliance, intimacy and
relatedness, and competence.5
Parents must accomplish all of this while running busy households and holding down
jobs. Today, approximately 60 percent of mothers are in the work force. Half of those have
babies under one year of age. The number of mothers of preschoolers in the labor force has
doubled over the last quarter century. In 1993, there were 9.6 million working women with
preschool children.⁶
Parenthood can overwhelm even the most mature mothers and fathers; it is certainly
stressful for the nation's large number of very young parents. Very recently, the birthrate for
adolescents has decreased slightly, although the problem remains serious. Each year teenage
mothers give birth to nearly 500,000 babies. Today, 3.3 million children live with adolescent
mothers. These young mothers have a particular need for parent education and support. They
are much less likely than other mothers to take advantage of prenatal care, and those under
age seventeen are more likely to have low-birthweight children - with all of the health and
developmental problems associated with that condition. In general, children born to teenage
parents, especially those living with their mothers alone, appear to be more likely than other
children to have continuing health problems.⁷
3
For all of these reasons, Starting Points recommended that community-based parent
education and support be available on a voluntary basis to all parents with children under age
three. It called for programs that increase understanding of child development and
parent-child relationships, provide models of parenting, and teach parenting skills. The report
stressed the importance of continuity - maintaining ongoing relationships with parents;
flexibility - creating services and supports geared to the strengths, styles, and needs of
individual families; and outreach - linking families with other parents and with community
resources.
Concerns of Parents
Few jobs are more vital to the well-being of children and society as a whole than parenthood;
yet few jobs are undertaken with so little solid information or training. Many Americans have
more resources in their homes for operating a new appliance, such as user manuals, on-screen
instructions, or toll-free customer support numbers, than for coping with a new baby.
This might not be alarming if parents and children were faring better. But participants
at Carnegie Corporation's meeting pointed to numerous, well-documented signs that many
American families are in crisis and that the trajectory toward trouble may be set even before
birth. Some of this evidence comes from parents themselves. Torn between the need or desire
to work and to care for their children, many mothers and fathers are worried - sometimes
guilt-ridden - that they do not have more time, more energy, more patience. Two-thirds of
employed parents with children under eighteen say that they do not have enough time for
their children.⁸ More than half - 55 percent - say that they are not doing as good a job at
childrearing as their own parents did.9
American parents are hungry for information and advice, a fact that has not been lost
on publishers, which have stocked bookstore shelves with scores of titles on pregnancy and
childbirth, child health and development, and childrearing. Parenting magazines, numbering
close to one hundred separate publications, are thriving. Many parents are also going on-line,
perusing electronic bulletin boards for advice about teething or toileting, finding child care,
or coping with sleep deprivation. A measure of parents' desperation is their eagerness to call
helplines. A single 800 number supported by corporate employers has been called by more
than two million parents. Even some of the corporate decision makers who established the
helpline have expressed surprise that so many parents are willing to rely on the guidance of
4
strangers. In short, vast numbers of Americans, representing every socioeconomic and ethnic
group, are worried about their parenting and are eager for information and support.
Research on the Status of Children and Families
Over the last two decades, research on the status of children and families in the United States
has confirmed parents' fears: that in too many cases our children's most basic needs are not
being met in their family settings. The data gathered in Starting Points indicate that despite
a great deal of knowledge about caring for young children the nation is not yet able to assure
their physical safety or survival. The risk to children's health and safety begins before birth.
In 1990, one in four pregnant women received inadequate prenatal care, and the number of
mothers who receive virtually no care during pregnancy is rising.¹⁰ As a result, the United
States has a worse low-birthweight rate than thirty other nations and a worse infant mortality
rate than nineteen. Childhood injuries are the leading cause of death among children ages one
through four. Many of these injuries are accidental; too many are not. In 1990 more than 2.5
million children were reported as being abused or neglected in the U.S. One in three victims
of child abuse was a baby less than a year old.
Millions of other small children may be physically safe and healthy but may face other
kinds of risks that jeopardize their emotional, social, and cognitive development. Recent
studies have found that the vast majority of child care programs in this country - 70 to 80
percent - are of mediocre or poor quality. The quality is even worse for infants and toddlers.
The services available are too fragmented and too poorly funded to provide adequate coverage
or quality to meet the needs of an expanding and changing preschool population.¹¹
These and other problems cut across all social and economic strata but are more
common among children of poor, teenaged, and single parents and among women who have
rapid successive pregnancies. Many of these problems can be linked to poverty. For example,
children from low-income homes are at significantly higher risk for infant mortality, low
birthweight, physical or mental disabilities, fatal accidents, and common health problems such
as asthma, frequent diarrhea, pneumonia, or decayed or missing teeth.¹² These findings are
especially sobering in view of the fact that the number of children living in poverty is large
and growing. Today, one in four infants and toddlers under the age of three - nearly 3
million children - - lives in a family with an income below the federal poverty level.
5
THE SOLUTION: BUILDING PARENTAL COMPETENCE
The challenge posed by Starting Points is to identify, replicate, and expand programs and
services that build parental competence and strengthen families. The group that gathered in
November 1994 took up this challenge.
Most individuals and institutions committed to family support and parent education
envision a future in which these services are available to every family that wants or needs
them. While that remains a distant goal, enormous strides have been made over the last
decade.
Local Efforts
A national database of family support programs from the Family Resource Coalition, which
is not exhaustive, lists hundreds of local programs. Surveys by the Robert Wood Johnson
Foundation have documented the existence of more than 2,000 organizations that characterize
their mission as providing family support.
State-sponsored Efforts
In the mid- to late 1980s, statewide parent support initiatives were launched in various parts
of the country, including Missouri's Parents as Teachers program, Maryland's Friends of the
Family and Family Support Centers, Connecticut's Parent Education and Support Centers, and
Minnesota's Early Childhood and Family Education Program. These programs differ in their
content, structure, staffing, and relative degrees of central authority and local autonomy.
Maryland has primarily targeted teen parents and their families; the other three states offer
services to all parents with young children. But each of them offers a basic menu of core
services, and all allow some local flexibility." These and other programs constitute persuasive
evidence that family support principles can be translated into effective, politically viable
policies at the state level.¹⁴ A recent typology of family support programs documented state-
sponsored family support programs in twenty-one states. These large-scale efforts provide
services at numerous sites, with a view toward eventually offering them on a statewide basis.¹ 15
Federal Efforts
Several federal educational initiatives aim to strengthen parent involvement. One, the Even
Start Program (part of the Elementary and Secondary Education Act of 1965), helps mothers
6
and fathers develop parenting and literacy skills while providing good-quality early childhood
programs. Recent non-legislative activities undertaken by the Clinton administration have
included building a Family Involvement Partnership for Learning, which pulls together groups
from many sectors to find ways to deal with family support issues.
Types of Family Support Programs
Family support and parent education programs have many sponsors and funders. They may
be organized by faith organizations, schools, hospitals, or health clinics. They may include
child care centers, parent hot lines, visiting nurse services, mental health centers, pediatric
intervention teams, correctional facilities, Big Brothers or Big Sisters programs, crisis centers,
community action agencies, employment and training centers, and dozens of other
organizations. These agencies and programs have different histories, grow out of different
disciplines, and draw their staffs from different educational backgrounds. For this reason, they
conceptualize their work differently. The common link is that the services they provide are
designed to strengthen parents' ability to care for themselves and their children.
Meeting participants noted that people tend to be most receptive to information or
advice at times of decision or transition. For this reason, the timing of family support/parent
education services is crucial. Three key transition points for young parents and young children
are birth and the perinatal period; the initial adjustment to out-of-home care; and the transition
to school. Most family support programs target at least one of these transitions. Depending
on the timing and nature of the intervention, programs may be home-based, institution-based,
or multifaceted.
Home-based programs. Rooted in the friendly visitor tradition of the last century,
the concept of home visitation rests on the premise that to foster the early development of
children, particularly at-risk children, one needs to work with parents in their home, observing
their interactions with their child in a natural setting and helping them to create an
environment from the outset that will support the child's healthy development. The services
may be offered through community-based organizations, preschools, health clinics, or
neighborhood family-child centers. The visitors may be nurses, social workers, or parent aides.
Some family support programs use home visits as the sole or main type of intervention;
in fact, these programs appear to be proliferating.¹⁶ They may vary in terms of the goals they
are pursuing, the particular information or skills they stress, the frequency and duration of
7
visits, and the characteristics of the visitors and the clients. But most home visiting programs
focus on parents' ability to provide the basic requirements for food, shelter, and health care
and to meet children's emotional, intellectual, and social needs. They teach and demonstrate
how to enhance parent-child interactions, create a safe, appropriate home environment, and
access health care and other services.
Because they occur in the home where family life takes place, home visitation programs
offer many advantages, which were discussed in some depth at the November meeting. Home
visits allow clients to receive services without traveling to an office or arranging for child care.
They encourage a very broad view of a family and place childrearing practices in the context
of their particular community and circumstances. By demonstrating their willingness to go
to the family's turf, visitors build a trusting relationship and create a "therapeutic alliance" -
a supportive, ongoing relationship that fosters parents' growth. In all of these ways, home
visits can potentially shift the ecology of family life, helping parents make the kinds of changes
that they themselves want to make.
Meeting participants also observed that home visits also have some drawbacks. In high-
crime areas, they may pose dangers to visitors. They may also be perceived as intrusive or
intimidating by parents, who may not want to expose their home lives to the scrutiny of
strangers. The substance, scope, or quality of visitors' work may be difficult to supervise. In
addition, home visits often present professional dilemmas, such as how to establish trust
without encouraging dependency. Some organizations now make use of "personal visits,"
which may take place at home or at a church, a neighborhood family center, a restaurant, or
wherever the family and the visitor can get together.
Institution-based programs. Other family support programs are based in insti-
tutions, such as child care centers, schools, community colleges, or health clinics. These
institutions may integrate family support with their core services, either making their existing
services more family supportive or adding a family support component to their spectrum of
services. Among the more intensive efforts are school-based programs for young mothers and
their babies. These programs usually supplement instruction, provided in appropriate
classroom settings, with personal guidance and mentoring from teachers, nurses, and social
workers. During pregnancy, the students receive routine prenatal care and are under the
supervision of nurses. The school curriculum includes subjects like planning for self-sufficiency
and delaying subsequent pregnancy. This type of program has been shown to increase the
8
likelihood of healthy pregnancies and having healthy infants, while reducing the risk of welfare
dependence. Students who begin the program early in their pregnancy show the best results.¹⁷
Multifaceted programs. Discussion at the Carnegie Corporation meeting reflected
the widespread conviction among family support advocates that neither home-based services
nor institution-based services, as stand-alone strategies, are sufficient. A decade of research
indicates that the most effective efforts take a more comprehensive approach, providing a range
of services at home and in the community. Some of these programs, particularly those
sponsored by state governments, are large in scope; others are more limited. But most provide
a basic menu of core services, including prenatal care and counseling; parent education covering
child development and a wide range of parenting skills; home visits; drop-in centers; parent
support groups; structured playtime for parents and children; information and referrals; and
counseling. Some programs also provide parent employment training and counseling, health
care, and child care for infants and toddlers.
Examples of Family Support Programs
Among the larger, more well-established family support programs are the following:
Parents As Teachers (PAT). A program for parents of children up to three years of
age, PAT is the largest comprehensive family support program in the nation. The PAT model
emphasizes regular home visits and individual contact with the parents. The state of Missouri
requires every school district to offer the program. An evaluation of PAT in thirty-seven
Missouri school districts found that participating three-year-olds scored above the national
norms on language and on school-related success.
Healthy Families America (HFA). This Chicago-based program adapted the innovative
Healthy Start initiative that originated in Hawaii a decade ago. Established in 1992 by the
National Committee to Prevent Child Abuse, in partnership with Ronald McDonald House
Charities, HFA is the nation's fastest-growing family support program. It has spread to more
than 170 communities in twenty-nine states and the District of Columbia. HFA provides home
visitor services to new parents and stresses continuing staff education and credentialing. It has
implemented a quality assurance plan for all sites and is now developing a family support
research network.
9
Birth to Three. Founded in 1978 in Eugene, Oregon, Birth to Three brings new
parents together to share experiences, learn about child development, form a support network,
and gain access to community resources. Programs are community- or school-based and are
run by professional staff assisted by volunteers. The program is open to all families in Oregon
and, to date, has involved more than 10,000 families.
Home Instruction Program for Preschool Youngsters (HIPPY). HIPPY serves parents
of four- and five-year-olds in over two hundred communities in twenty-two states. Parent
aides visit participating families at home twice a month over a two-year period; they present
and model a curriculum of activities for parents to follow with their children. Twice-monthly
group meetings led by a professional program coordinator help parents share educational
approaches to use with their children. A study that followed participating children through
their school careers until grade ten concluded that HIPPY has a positive, sustained impact on
achievement and adjustment in school.
Avance. Founded in Texas in 1973, Avance serves low-income Mexican American
families and their young children. It offers classes for mothers and fathers, day care for the
children, and in-home visits from educators. Evaluations show that as a result of their
participation in the program, parents provide more educationally stimulating and emotionally
supportive home environments for their children, use less restrictive and punitive discipline,
and make greater use of community resources.
MegaSkills Program. This is a less intensive model that offers workshops for parents
to help them carry out learning activities at home. It has trained more than 4,200 workshop
leaders from forty-five states. Evaluations of children whose parents have received MegaSkills
training show improvements in the children's achievement test scores, attendance, time spent
doing homework, and time spent with parents.
Minnesota Early Learning Design (MELD). This Minneapolis-based organization helps
new parents improve their child-rearing skills and promotes children's development by
disseminating training and curriculum programs that have been adopted in more than 150
educational and social agencies in twenty-five states. MELD's parenting education programs
have been used successfully to support the healthy growth and development of children with
disabilities, new immigrants, and adolescent mothers. Research on these programs has revealed
reduced family isolation and improved parenting skills.
10
Parent-Child Centers. This initiative originated in the 1960s as a key component of
the Head Start program. The program was cut back dramatically in the 1970s but has grown
slowly over the past two decades. In 1992 there were 106 centers serving roughly 20,000
children under the age of three. The program combines home visits beginning during
pregnancy; activities geared to teen parents and their families; high-quality child care; and early
intervention for children with special needs.
IMPACT OF FAMILY SUPPORT AND
PARENT EDUCATION: THE EVIDENCE
Research conducted over the last three decades suggests that a significant portion of the
problems afflicting the nation's children can be tied to parental behavior - in particular, the
health-related behaviors of pregnant women - and to the quality of care that parents provide
to their children.¹⁸ The question remains: Can family support and parent education programs
strengthen parents' ability to care for their children and thus improve results for children?
The evidence is promising but not conclusive. Comprehensive, multifaceted family support
programs are difficult to evaluate: they encompass many variables, and they try to gear services
to the needs of individual families. Because different programs work with children of different
ages and target different kinds of families, it is difficult to compare them. For these reasons,
there has been little systematic research on their effectiveness.
On the other hand, evaluations of more narrowly focused programs - those stressing
home intervention and parent education - indicate that their effects can be impressive.
Effective programs begin with prenatal care; they are comprehensive, intensive, and long
lasting. Such programs appear to be particularly helpful to low-income, single, adolescent
mothers, whose children are at high risk for academic failure and a multitude of other
problems. Research shows that it is possible, although difficult, to improve results for these
children while reducing the risk of welfare dependence, antisocial behavior problems, and
violence.¹⁹
Meeting participants noted that home intervention programs appear to be a particularly
promising approach. Studies conducted over the last ten years have produced some evidence,
based on a small number of high-quality research and demonstration programs and well-
evaluated service programs, that regular home visits can enhance children's, and sometimes
parents', development. Two large studies conducted in Elmira, New York, and Memphis,
Tennessee, suggest that early childhood home visitation services can reduce poor pregnancy
11
results and dysfunctional caregiving as well as lower the risk of welfare dependence and youth
violence among low-income families. Home visitation programs also appear to be cost-
effective. One study showed that, by the time they reached age four, children in low-income
families who received home visitation from the prenatal period through the second year of life
cost the government $3,313 less than did their counterparts who received no services.²⁰
The research further suggests that the effects of home intervention programs during the
preschool years can persist over an extended period. Some longitudinal studies show that IQ
gains associated with such programs persist into the elementary school years. These gains do
tend to fade after several years, but researchers note that the boost during the crucial "school-
readiness" years may contribute to subsequent achievement.²¹
Efforts that focus on helping parents become stronger partners in their children's
learning have been shown to have a significant positive impact on children's cognitive
development, school performance, and social functioning. Numerous studies over the last
three decades have shown the promise of programs designed to assist parents of preschool
children, including family literacy programs, projects that integrate adult and early childhood
education, and family intervention programs designed to help parents become better partners
in their children's schooling.22
THE CHALLENGE: MOVING FROM
PROGRAMMATIC TO SYSTEMATIC EFFORTS
The literature on family support and parent education refers frequently to an evolving family
support "movement." This usage reflects the fact that many researchers and practitioners in
the evolving field of family support are joining forces - in professional organizations and
publications and at conferences and other public forums - to urge a shift in emphasis from
programmatic family support efforts to a more systemic approach. Family support advocates
have begun to press decision makers in many spheres of public and private activity to infuse,
into their organizations' policies and practices, a set of family support principles that include:
1) an emphasis on prevention, resulting in programs that do not just treat problems but seek
to prevent them; 2) an ecological approach, resulting in programs that take into account the
needs and conditions of the child, family, and community; 3) a developmental view of
parents, resulting in programs that support the growth and learning of parents as well as
children; and 4) a belief in the universal value of family support, resulting in programs that can
strengthen and empower all kinds of families.²
12
Organizations can also infuse into their policies and programs some of the best practices
of effective parent education programs, including efforts to establish and maintain ongoing
relationships with parents; gear services to the strengths, styles, and needs of individual
families; model positive parent-child interactions; teach new parenting skills; increase
understanding of child development; provide a network of social support with other parents;
and facilitate parents' access to community resources.
The family support "movement" proceeds from the premise that family support and
parent education cannot succeed as isolated efforts. In particular, families living in poverty and
in conditions of constant stress have urgent needs that stand-alone programs or parenting
classes alone cannot meet. To serve these families, parent education and family support
programs must be embedded in a coordinated array of community-based services including, but
not limited to, health care, child care, literacy classes, and job training.
A number of the larger, more well-established programs have attempted to move in the
direction of systemic reform by providing training and technical assistance to community-based
agencies or school districts that wish to provide more support to the families they serve.²⁴
Their aim is to move, over time, to a model of family support that encompasses all of the
services available in a given locality. In this sense, the family support movement is allied with
"coordinated services" efforts in education, which have gained momentum in recent years.
Informed by a growing network of advocates and practitioners, the coordinated services
movement tends to focus on school-community linkages, envisioning the school as a hub of
services - including education, health, recreation, and social services - for all the residents in
its vicinity.25
The family support movement seeks to reconfigure delivery systems as well, with an
emphasis on services to young families. Existing services derive from multiple antecedents and
many disciplines and are supported by many different funding streams.²⁶ The crazy quilt of
delivery systems now in place, particularly for poor children, rarely meets the needs of the
"whole child" or the "whole family."2 The comprehensive, multifaceted programs that are
now operating in many parts of the country have taken strides in that direction, by reaching
out to local service providers and helping them to incorporate family support principles into
their day-to-day work. But they cannot address directly the obstacles that tend to undermine
efforts at coordinating and transforming delivery systems, such as categorical financing,
interagency turf battles, and political conflict.
13
Despite these limitations, comprehensive programs are putting down roots in many
parts of the country and offer many opportunities for scaling up family support and moving
toward a more systemic approach.
PART II. LESSONS LEARNED
THE MAJOR SERVICE SECTORS
Scaling up family support is not an end in itself. It is, rather, a broad strategy for investing
in the next generation and thereby protecting and strengthening the nation. To succeed, the
endeavor must engage every sector of American society. With this in mind, the participants
at the Carnegie Corporation meeting undertook a sector-by-sector review of efforts to support
families, delineating lessons that may inform the process of going to scale. In the process, the
group posed two key questions: First, is it possible to take an existing delivery system and,
by adding or strengthening family-oriented services, convert it into an effective family support
and parenting education program? And second, is it possible to mesh the efforts of numerous
sectors into a network of services designed to strengthen families and build parental
competence?
Child Care
Most preschool children - by some estimates as many as 98 percent - are in out-of-home
child care at some point before they begin kindergarten. Because they have contact with so
many families, child care providers are ideally positioned to deliver a variety of family support
services. Child care providers may be based in schools, homes, health facilities, or community
institutions such as churches. Many of them, wherever they are based, share a commitment
to early prevention, a willingness to work with families, and an awareness of the
developmental stages of parenting. Some of the larger, better-designed child care programs,
such as Head Start, have strong parent involvement components. Many smaller programs and
providers also make efforts to support families, particularly through parent education. Some
see parent education as part of their mission from the start; others come to parent education
as a secondary focus.
For all of these reasons, meeting participants suggested that child care, as a service
sector, should be a strong contributor to the process of scaling up family support. A number
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of organizations are making active efforts to infuse family support principles into early care
and education projects. For example, the Parent Services Project, which seeks to strengthen
child care providers' capacity to support parents and families, has attracted both government
and foundation funding and is now functioning at more than one hundred sites around the
nation.
These efforts are encouraging. Without additional support and resources, however, few
child care providers today are in a position to take on new challenges. As Starting Points
documented, the vast majority of existing preschool programs provide substandard care and
lack the funding they need to improve quality. Most cannot hire enough adults in proportion
to the children in their care or pay salaries higher enough to attract or retain highly qualified
teachers or administrators. Until these hurdles are overcome, child care cannot fulfill its
promise as a key provider of family support services.
School-based Programs
Parent education is a process by which one generation transmits values and cultural patterns
to another. It begins long before prospective parents make their first prenatal visit. For this
reason, schools can play a key role in preparing young people to become good parents. Many
Americans are convinced that government, through its schools, should not be in the business
of promoting a particular set of values, mores, or lifestyles, and that other institutions, such
as faith institutions or community-based organizations, should have more influence in this
effort.
Nevertheless, because families tend to be smaller and more isolated than in past decades,
and because family life is more pressured, many parents welcome the role that public
institutions are playing in parent education, which in public schools is often called "family
life education." While a vocal group of conservative parents vigorously opposes family life
education, the majority of parents - according to one survey as many as 75 percent - say that
they support this trend.2⁸
Parents are not alone. Most state agencies and professional organizations also embrace
the notion that children and adolescents should receive age-appropriate family life education
and education for parenting. Despite their support, there has been little systematic research
on school-based preparation for parenthood. Its prevalence can be described only in the
broadest terms: forty-seven states have laws or policies that mandate or recommend some level
15
of family life or human sexuality education between kindergarten and grade twelve. Of these
states, thirty-nine have developed general curriculum guidelines. Few are comprehensive in
their coverage of key topics.²
Even so, young people manage to receive little education for parenthood in the public
schools. Usually, the topic of parenting is presented only briefly, and only to the upper
grades. There are relatively few comprehensive, developmentally oriented family life education
programs. Where they do exist, scaling them up has proven difficult because of fiscal
constraints as well as political opposition. Moreover, there is little consensus on the content
of such programs, and most states leave the specifics up to local school districts and
communities. Meeting participants commented that standards, where they have been written,
tend to be too prescriptive; they may institute a one-size-fits-all approach that cannot
sufficiently accommodate cultural variation or reflect a community's wide spectrum of attitudes
and values. Schools may be able to avoid this pitfall by working in close partnership with
community-based organizations as they design and implement parenting education initiatives.
Some participants at the Carnegie Corporation meeting predicted that family life
curricula would be better accepted if they were redesigned as solidly academic courses in
human development or life sciences. In this form, they are less likely to be offered as electives,
sacrificed to "back-to-basics" movements, or eliminated as "frills" when budgets are cut. Others
observed that programs like family life or human sexuality or even health education remain
on the margins of the school curriculum because schools do not test for them. Still others
pointed out that parenting education curricula will not be widespread in schools until teachers
are given focused, specific preparation to teach them, both in schools of education and in-
service programs.
Many educators argue against a stand-alone parenting education curriculum, urging an
approach that imbeds preparation for effective parenthood into the overall pursuit of
dispositions and behaviors that are desired for children. They say that parent education should
not only be built into the formal curriculum; it should be infused as well into extracurricular
activities and, indeed, into the ethos of the school itself.
Public schools may also play a role in the provision of family support services. They
are, after all, common to every community and can often play a crucial role in bringing
together all of the community's stakeholders. In some cases, school buildings are serving as
16
community centers; in other cases, schools are adopting the "full-service school" model.³⁰ The
schools do not provide the services, but they share facilities with other agencies and
community-based organizations and become a hub of services. A case in point is the Caring
Communities Project in Missouri, which uses the school as the hub of a network for child care
providers. The program has been well accepted. It has used the rhetoric of shrinking
government and community-based decision making and ownership as the rationale for
wrapping services around the school.
Welfare
The 1990s appear to be an opportune time for bold efforts in welfare. Welfare reform has been
hoisted high on the national agenda and is likely to remain a critical social and economic issue
in the years to come. Because the status of the nation's children should be more central to the
welfare reform debate, any consideration of family support must take this issue into account.
According to one meeting participant, who is a government official steeped in the welfare
debate, focus groups held around the country indicate a widespread belief that welfare reform
efforts should focus on small children.
Missouri is an interesting case in point. The Missouri child welfare system provides
parent education, mandating it for those parents in the child welfare system who have a
confirmed history of abusing or neglecting their children. At the same time, Missouri offers
many other parents a strong incentive to participate in parent education on a voluntary basis.
It is the only state where involvement in the Parents As Teachers program counts toward the
twenty hours per week of work required to maintain one's standing in welfare.
Health
As a sector, health care is a very promising delivery system for family support and parent
education and can be a vital contributor to any effort to scale up support for parents. It is,
after all, an entry point for services or help. Of the 4 million births that take place each year
in this nation, the vast majority occur in hospitals or at least in the presence of medical
personnel. Moreover, good well-baby care includes periodic visits that provide an opportunity
to expand parent education and support. Another strength of the health care system is the
therapeutic alliance - a trusting relationship between provider and patient. Finally, the
expansion of the health care system and the extension of its role to include counseling parents
may be more palatable politically than the expansion of other kinds of services.
17
These are the pluses. At the same time, there are several factors that may limit the
effectiveness of the health care system in providing family support. The growth of managed
care and the pressure to contain costs have led to the rapid discharge of new mothers,
sometimes within twenty-four hours of giving birth. As a result, an important opportunity
is lost to work with parents at a critical time. The same forces have put pressure on
pediatricians to move patients through their office at a rapid rate, leaving many questions
unanswered and many anxieties unrelieved. There are fewer public health nurses to make
home visits to newborns and provide support to parents. And finally, the fragmentation of
health services means that a mother's health problems - including stress or depression - may
not be treated, even though she takes her child for regular well-baby visits.
The key to scaling up family support, from the viewpoint of health care, is to change
incentives in the system so that managed care organizations, such as health maintenance
organizations (HMOs), are rewarded for taking on a broader role in relation to families. Since
parents value expanded service, it may well prove to be a marketing advantage for these
organizations. Over time, the routine provision of parent education and family support may
be viewed as a strategy that is in the financial interests of health care providers. A first step
is for these organizations to determine which support services that parents really want. Once
this is established, health care providers must become more knowledgeable about these services
or be able to make appropriate referrals. They must ensure that their personnel, including
physicians, have the training they need to support and educate parents.
One innovative effort to infuse parent education into health care delivery has been
supported by the New York-based Commonwealth Fund. Known as Healthy Steps for Young
Children, this project integrates a parent education component into the basic package of
services provided by hospitals and HMOs to families with new children. Healthy Steps seeks
to expand pediatric primary care to include information on child development and guidance
and support for parents beginning in the late prenatal period and continuing through the first
three years of life. The project plans to pilot fifteen or more local initiatives, each a multiyear
partnership of the Commonwealth Fund, a local funder, and a local health care provider.
Criminal Justice
Of the 80,000 women incarcerated in the nation's jails and prisons, 76 percent have at least
two children. Most were the primary caregivers of their minor children before their
incarceration. Many inmates will resume their parenting responsibilities when they are
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released from custody, but they will do so under very trying circumstances. Most incarcerated
mothers see their children infrequently and in stressful settings. (Male inmates tend to have
more frequent contact with their children, because the children's mothers are more likely to
arrange visits.) Not only the parents, but also the children, suffer from these constraints.
Approximately 1.5 million children have at least one parent who is in prison. Studies have
documented the traumatic effects on children of their parents' incarceration. Children of
prisoners are five to six times more likely than their peers to become incarcerated later in their
lives.³¹
In some places, the criminal justice system has taken up the challenge of providing
family support and parent education to inmates and their children. The oldest such program
functions at the Bedford Hills, New York, Women's Correctional Facility, which has
established a nursery for mothers who give birth while incarcerated, a parenting center, and
a children's center for visitors. Bedford Hills also offers a variety of parent education courses
taught by qualified inmates. Other correctional facilities across the nation are beginning to
create policies and programs that maintain contact between inmates and families, build parental
competence, and facilitate family interaction through structured visiting (including extended
visits with children). These efforts are only beginning, however.
MAINSTREAM INSTITUTIONS
Faith Institutions
Faith institutions are among the only places in the nation where more than one generation gets
together at the same time on a regular basis, providing a natural setting for parent education
and family support. From a historical viewpoint, faith institutions are uniquely positioned to
play a key role in the effort to scale up successful parent education and family support
initiatives.
Until the early twentieth century, churches were the major and sometimes the only
institution in the nation that responded to the needs of children, especially those in crisis.
Today, with the exception of public schools, congregations serve more children, youth, and
families than any other institution in our nation. Many have developed family ministries,
equipping lay church members to provide needed family support services, providing self-help
support, and offering professional family counseling. While faith organizations usually have
physical space and numerous volunteers, they are often strapped for funds. Many of these
organizations are competing for smaller and smaller pools of money. Some communities that
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lack the resources to support their own parishioners are beginning to tap wealthier
congregations, seeking aid or sponsorship.
Recent changes in the church-going habits of many Protestants affect the churches'
capacity to provide family support. Today's families look for churches where they will feel
comfortable; they do not necessarily seek the denomination connected with their own
upbringing. The fastest-growing churches may have no affiliation with a national church body
or office. As a result, multiple strategies are needed to reach a large number of congregations
efficiently. Good candidates for community planning efforts are interfaith and ecumenical
coalitions. They often operate somewhat like a nonprofit but act as an umbrella group
representing a number of churches. They sometimes also operate direct service programs -
often with great efficiency.
Historically, predominantly black churches have grounded their family support efforts
within families and within communities. Until recent decades, predominantly white churches,
in contrast, have tended to care for needy children by removing them from the family and
community and placing them in residential homes, orphanages, and foster care. Today, black
churches remain very active in providing family support and offer huge potential for helping
to scale up community-based services.
Nationwide there are at least 75,000 black churches, serving more than 24 million
churchgoers. Many of these congregations reinforced their traditional community outreach
role in the 1980s as funding for social programs for minorities and the poor dried up. A recent
study known as the Black Church Family Project studied a representative sample of 635 black
churches and found that two-thirds of them had at least one community outreach program.
More than half of these programs address the needs of the family unit.³²
Increasingly, black churches are being asked to anchor services to communities that are
in transition. The churches have, to some degree, been responding to these problems and
appear to be a ready instrument for immediate transfer from public services to private
community-based services. Crucial infrastructure questions must be addressed, however. When
a religious community becomes a major provider, the dollar resources are often reduced and
issues of quality and evaluation are given short shrift.
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Funding is not the only issue. There are many churches, particularly smaller ones, that
are very community oriented and would be ready and willing to offer family support, but they
do not know how to do it. If they are to play a role in scaling up family support, faith
institutions of all kinds need help to build capacity.
Business
The corporate sector's involvement in parent education and family support is a recent
phenomenon that has grown out of employers' efforts to help employees arrange for child
care. A survey conducted in 1982, for example, found that 600 companies nationwide
provided employer-supported child care; by 1990, the number had grown to 5,600 companies.
Human resource executives say that the top three reasons for providing family support services
are employee morale, recruitment, and retention.³³
Today, the case is growing stronger for helping employees balance their work and
family life. Research by companies like IBM and Johnson & Johnson has found that these
supports result in a direct, measurable benefit to businesses. Businesses are building a portfolio
of success stories. There are many model programs and examples of businesses' successful
community investment projects. Indeed, companies are competing with each other to excel
in this area. One chief executive officer was recently asked what he would say to a peer who
resisted the idea of family support. He answered: "I'd hope he was a competitor and then I'd
keep my mouth shut."
Corporations are beginning to engage consultants to advise them specifically on family
and workplace issues. This is consistent with the trend toward outsourcing many human
resource functions. Some of these consultants began as child care resource and referral agencies
- the main concern of business ten years ago - and then developed a much broader focus,
helping corporations create more family-friendly policies and environments and change their
business culture to introduce the flexibility needed by working parents. Numerous companies
have asked consultants to help them integrate into their employee benefit packages a range of
family support services, such as prenatal classes, parenting seminars, and hotlines. Many
corporations also offer referral services, but a few are concluding that it is not enough to refer
employees to care in the community, because there may not be enough care, or the quality of
care may not be good enough. These companies have begun making investments in the long-
term process of building the supply and increasing the quality of local services.
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These trends are encouraging, but meeting participants emphasized that family support
is by no means universal in the business community. Large companies tend to address family
concerns, but many employers remain relatively unresponsive to parents' problems or needs.
Moreover, in this period of corporate downsizing, the contingent workforce, made up of
employees who do not receive benefits of any kind, is growing. It is now 38 percent of the
workforce and is expected to grow to about 43 percent. These workers have little access to
employer-sponsored family support services.
The bottom line is that businesses have made strides over the last decade toward family-
friendly policies, but they have a long way to go. A recent study by the Families and Work
Institute found that most companies now provide maternity leaves and offer parents flexible
work schedules, such as part-time schedules or flextime. Only 28 percent offer child care
leaves for mothers, however, and only 13 percent sponsor on-site child care centers. The
steepest obstacle to change appears to be concern about cost and equity. Many corporate
decision makers continue to view family support as a "frill" that has no place in today's tough
environment, where only lean-and-mean companies can compete successfully. They are also
concerned about the problem of offering benefits only to one segment of their workforce.
They fear that if they provide support and education to parents with young children, they will
be forced to offer equivalent benefits to other employees as well, such as those with ailing
parents or troubled adolescents.
The Media
Parenting skills and information are no longer passed between generations or over backyard
fences as readily as they once were. Americans are therefore looking to the media to provide
parenting know-how, as they do for information about so many aspects of life.
In recent years there has been a marked increase in the publication of handbooks for
parents. Of the hundreds of books and publications on parenting available at any given
moment in bookstores and libraries, most address new parents. Periodicals with large
circulations, such as Parents Magazine, with a circulation of nearly 2 million a month, not only
offer advice to new mothers and fathers but also have the capacity to generate research by
surveying their readers.
At the same time, newsrooms are undergoing great change, driven by financial pressures
and declining readerships, and are looking for consumer relevancy and community
22
connections. One result is the development of civic journalism. There are new models of
reporting on children all around the country, and full-time "children's beats" are enjoying a
marked increase. A recent study of sixty-one newspapers and news services by the Casey
Journalism Center found that more than half have added children's and/or family beats in the
last three years. The news media today are devoting more space and resources than ever before
to this beat, offering "news-you-can-use" for parents and stories that search for explanations
of the forces in society that imperil children and families.
The electronic media can also play a role in strengthening parent education. Videotapes
hold great promise for parenting education, since four out of five American homes have a VCR,
and high-speed tape duplication has made it economically feasible to think of videotapes as
give-aways. A case in point: McDonalds and the New York City Department of Mental
Health have produced a videotape aimed at reaching at-risk adolescent parents with
information and messages geared to preventing abuse. Commercial talk radio is another
potentially powerful outlet for parenting education, and it has the advantage of being
interactive.
Meeting participants identified a number of gaps that the media need to close. Stories
on parenting tend to focus on young children; parents of adolescents receive far less attention,
information, and support. Television and radio coverage of parenting issues could be more
consistent. Child development specialists often make guest appearances on TV and radio, but
at present there is no national talk show that focuses on child development and parenting.
And finally, media critics note that both print and electronic media need to broaden their
concept of parenthood to include fathers more consistently.
GOVERNMENT
Federal Government
Federal initiatives in the realm of family support and family preservation have generally been
pursued within the framework of education, welfare reform, child care, and youth programs.
There have been some recent efforts to strengthen services to families with young children,
notably the Even Start Program, the introduction of Early Head Start as part of the Head Start
reauthorization bill, and the 1993 Family Preservation and Family Support Act.
The current political climate dictates against dramatic federal efforts in the realm of
education. Today, major federal initiatives in education are unlikely to succeed unless they are
23
voluntary, amenable to considerable flexibility, and based on local- and state-driven solutions.
They also need to be comprehensive, with family involvement in learning as part of a broad
set of comprehensive solutions. They need to allow states and communities that have bold
action plans to seek waivers to decategorize education programs, allowing a more
comprehensive approach.
Despite clear limitations, the federal government can be a catalyst for change by
supporting, modeling, linking, and assessing efforts to provide family support. In particular,
it can support a "visioning" process; fund research; facilitate and support collaboration; describe
and ensure equity; and offer training, technical assistance, and leadership development.
State Governments
The impetus for expanding family support over the last decade has occurred, for the most part,
at the local and state levels. As a result, many states have continued to take innovative
approaches to family support issues. Some have created programs that establish stand-alone,
community-based family resource centers and/or home visiting programs; others have built
family support initiatives into efforts to reform the educational, welfare, and public health
systems. Family support principles - including an emphasis on family-centered, preventive,
comprehensive, community-based services - have also been built into state authorizations for
existing programs operated by numerous state agencies. All of these actions reflect the
growing recognition by state policymakers that their constituents are worried about the severe
stress experienced by many families and want state government to respond with services that
are accessible, effective, and closely connected to the actual needs and strengths of families and
communities.
Meeting participants observed that, in order to expand family support, state
governments need to be active in five areas:
1) Providing leadership. State governments must create a vision that leads to a strategic
planning process, providing incentives, standards, and supports and sustaining commitment to
ongoing initiatives despite changes in administration. The state can create an environment
for innovation by partnering with other sectors, including the private nonprofit sector, the
corporate sector, and local government.
2) Establishing a policy framework. State agencies can often succeed by taking a single,
relatively simple concept and then making a sustained, systematic effort to build around it.
24
Vermont has done this, for example, with Success by Six, which wraps its family support
efforts around a home visiting program. As they develop policies and programs, states need
to make a commitment to going to scale, using cross-system approaches that take into account
all the services provided in the state, not just those identified as family support programs.
3) Ensuring an adequate and stable funding base. States must analyze and publicize areas
in which current investments are not paying off; increase investments overall, including
through the creative use of federal dollars; look for opportunities to invest in prevention; and
demonstrate that government can make responsible choices.
4) Developing partnerships at the local level. States provide a lawful structure for local
efforts. At the same time, they must build relationships with local government, including
school districts and neighborhood organizations. By offering reinforcement and public
approbation to promising local initiatives, states can make it possible for best practices to go
to scale.
5) Assuring quality. Today, many states are introducing or reinforcing a results-based
approach to program planning and implementation. But in setting standards, states must also
provide the assistance that local agencies and organizations need to meet those standards. Local
initiatives need information and assistance with planning, training, financing, evaluation, and
the use of electronic tools to coordinate efforts.
Local Governments
There is growing consensus among policymakers and taxpayers alike that grass-roots,
community-based human services make more sense than categorical programs, with their top-
down planning. It is recognized that, to function effectively, family support programs require
substantial planning at the local level where the families who need the services will access them
and use them. And yet, as things now stand, three out of four American cities have no formal
written policies or plans for services to families.³
Local governments bring numerous advantages to the task of establishing or expanding
family support services. They are often better able than other sectors to come up with flexible
initiatives that respond to emerging needs, and they are usually better positioned to take risks
with funding and program development. They can form partnerships with local businesses,
school districts, charitable organizations, and nonprofit organizations. They can act as role
models and test new initiatives by piloting programs for their own employees. Finally, local
governments are in a good position to build family support principles into local economic
development strategies.³⁵
25
In more and more communities around the nation, both elected officials and private
citizens are recognizing the link between the well-being of families and the vitality of the town
or city or county as a whole. In particular, they are realizing that when families fail or flee,
a community's economic prospects plummet. And yet, faced with severe fiscal constraints,
many policymakers are reluctant to launch new family support initiatives.
But even financially pressed communities can strengthen family support by reviewing
the existing services delivered by a wide variety of local government agencies and finding ways
within those systems to better serve families. They can devise strategies for building the kinds
of relationships among existing institutions and agencies, such as schools, libraries, health
services, police forces, and recreation departments, that will support the healthy development
of all of their children. They may want to start by evaluating the "family friendliness" of
current policies and practices, with a view toward strengthening those that make the locality
a good place for families to live and eliminating those that do not. In some cases, relatively
simple changes can make a big difference, such as shifting the hours when agencies are open
to match the realities of families' lives.
This kind of appraisal is certainly doable and can lead to a more comprehensive
assessment of the needs of children and families if there are individuals and organizations
prepared to carry it out. If not, then expanding family support requires a long-term
commitment to developing leadership and to building, over time, a broad community coalition
- in short, a constituency for change that comes together around a shared vision. The vision
may be broad, based on a collaborative process that allows people to think together about how
families can be better served, especially those with the greatest need. But it should also stress,
at least at first, a single critical issue (prenatal care, or immunization, or affordable child care)
that can help to focus community interest and activism.
The process of elaborating a vision should lead to a plan for cooperation across levels
and departments. The plan should establish benchmarks, stating precisely what the
community wants to achieve and how it can measure success. The plan may involve
identifying, expanding, and linking effective community programs; it may call for innovation.
In any case, it should identify every possible source of funds and other resources for family
support projects - not only government sources, but also the philanthropic and business
communities. Finally, the plan should encompass evaluation. An independent monitoring
26
process helps to ensure that a community's policies and practices - both old and new - move
it toward the results defined during the visioning process.
PART III. GOING TO SCALE
DEFINING "SCALING UP"
Today there are thousands of scattered initiatives across the nation aimed at strengthening
parental competence and helping young families thrive. A multitude of parent education
programs operate under many guises. Scaling up these efforts does not only mean showcasing,
evaluating, and expanding effective initiatives; it means reaching a population that is large
enough to allow testing of the program's capacity to improve results on a systemwide basis;
and also implementing the program in a sufficiently large jurisdiction to test it in a variety of
settings, where diverse obstacles will be encountered.36 Ultimately, scaling up involves creating
the infrastructure for nationwide high-quality services for families and building a professional
field of effective initiatives that are nailed into policy and resources.
In a fully scaled-up system of supportive services, the vast majority of people who need
services and are eligible to receive them would be reached. As one meeting participant noted,
even 96 percent penetration does not suffice if the 4 percent who are not served represent a
particular group that has demonstrable need. A long-range plan therefore should, over time,
move the nation toward the goal of making services available to every family that wants to
take advantage of them.
Many sectors of the society and as many organizations and individuals as possible must
be engaged on behalf of parents and their young children - a process that may involve the
shifting down of responsibility from a central (federal or state) authority to local community
groups. Because federal and state governments have historically played a strong role in
assuring equity, this complex transfer of power may jeopardize the rights of disadvantaged or
marginalized populations. This is not the inevitable outcome, however. States that are now
in the process of scaling up parent support, like Missouri and Vermont, appear to be taking
this danger into account and are building slowly with considerable attention to what happens
to equity as devolution proceeds.
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CREATING SYSTEMS OF SERVICES
Family support may be seen as both the provision of information and supports to families
with young children and the creation of systems of services that enable families to get the help
they need to raise their children. To be responsive to children and their parents, services must
be linked because families' needs and strengths do not come in neat packages. Policymakers
are beginning to recognize that effective parenting education and family support must be
comprehensive in purpose. They are beginning to think about family support programs,
including parenting education efforts, as part of broader efforts to reconfigure systems of
service.
The challenge of "going to scale" raises a crucial issue: Is the priority to scale up
family support as a set of discrete programs? Or should policymakers be working toward
scaling up family support in the context of efforts to build a comprehensive system of services?
Is it feasible in practice to start categorical and then build programs into systems?
Recent experience suggests that it is reasonable to start by scaling up successful
programs. All of the states that have launched ambitious family support initiatives began by
creating discrete programs within a particular system, usually education or social services. In
each instance, the initiative is now "moving out"- that is, taking its place as part of broader,
cross-agency efforts to support families and reform delivery systems.
SCALING UP PARTICIPATION
The challenge, broadly stated, is to rebuild communities so that supports are in place to meet
the needs of children and families and to make or revise policy at the state and federal level
to facilitate that process. For this to happen, family support principles must be infused into
mainstream agencies and organizations at every level. They must be communicated in ways
that will make sense to large numbers of people who may not be acquainted with them.37
As part of that process, policymakers must address the question of whether family
support and parent education services should be provided on a universal basis, or targeted to
particular populations. This issue sparks heated debate, even within the family support
movement. Historically, categorical approaches have often reached dead ends.
Some researchers, practitioners, and policymakers argue for universal programs, with
different supports for different kinds of families, based on indicators showing that virtually all
28
families are under stress. A concern is that targeted family support echoes the biases of the
charity organization movement of a century ago, by reflecting the assumption that poor
people, people of color, and immigrants need parenting education in order to absorb the
values, practices, and lifestyles of the dominant culture. Finally, supporters of universal services
cite political considerations: many legislators are on record that they will only vote for
universal programs that benefit all of their constituents.
Proponents of targeted services, on the other hand, argue for political realism. They
assert that, in an era of scarce resources, services should be directed to the families and children
who need them most - poor children and those demonstrably at risk of developmental delays,
health problems, and school failure. They observe that the argument for universal services
may not survive massive taxpayer resistance to increased social spending. As one participant
commented, "Today the alternative to doing everything for everybody may be to do nothing
for anybody."
Finally, they note that the case for universal services rests on the premise that all
parents and their children stand to benefit from access to family support services, particularly
if those services are designed to meet parents' needs as they themselves define them. Existing
evaluations have not, however, been able to demonstrate conclusively the benefits of family
support interventions for middle-class families.³⁸ This may reflect flaws in the evaluation
design, rather than program weakness. In any case, the universal argument cannot be made
persuasively until more evidence is gathered. The need for evaluation is not limited to the
benefits for middle-class parents. In general, policymakers need more solid information on the
impact of parent education and family support initiatives on various populations.
SCALING UP EVALUATION
Most evaluations of family support programs have been limited to a short time span - three
to five years at most. To understand the impact of family support over time, the obstacles to
change, and the kinds of programs that can overcome those obstacles, more long-term studies
are needed.
There is a need to know whether programs designed for families with young children
are likely to have a sustained effect on those children, including their own ability to be
effective parents two or three decades later. Understandably, most politicians and the public
are unwilling to wait twenty years to test a program's impact. And given today's budget
29
constraints, it is very difficult to secure funding for very long-term studies. As a result, big-
picture evaluations may not be viable at the present time.
It is possible to document more fully and more effectively a range of indicators that
shed light on the impact of family support. These data can help to shape new legislative and
programmatic initiatives. Some researchers argue for "reinventing evaluation" - devising
innovative knowledge development strategies that can help policymakers drive change and can
give local communities the capacity they need to pursue effective, cost-effective strategies.
Rather than asking whether family support works, researchers need to ask: What works best
for whom?³⁹
LESSONS LEARNED FROM CURRENT EFFORTS
While continued research and evaluation efforts will help policymakers and practitioners target
resources and improve results, enough is known about family support to counter the
widespread perception that nothing works when it comes to improving the prospects for vast
numbers of at-risk children. Indeed, the task of scaling up family support is already in
progress in a number of states, including Maryland, Minnesota, Missouri, Kentucky, Tennessee,
and Vermont, and in many communities. From these, a number of crucial lessons about the
process have been learned:
1) Scaling up high-quality programs in any significant way requires enormous investments
of time, energy, and resources. An urgent priority is the creation of an infrastructure that
strengthens and coordinates funding, training, quality control, and evaluation.
2) The federal government must not relinquish its stake in family support. States and local
communities need assistance as they think through the best ways to approach complex infrastructure
issues. In particular, family support and parent education require a broad perspective on training,
capacity building, and evaluation.
3) It is impossible to overstate the critical importance of leadership and political skill,
particularly the ability to read what will motivate policymakers and build political will. The
political entrepreneurs who have successfully brought programs to scale have been attuned to the
kinds of program design and strategy that would make their initiatives politically marketable
within their states. It is essential to tailor advocacy for these kinds of programs to local political
circumstances, and to fit them into the local political agenda.
30
4) Most states that are scaling up programs have been able to sell, to their legislatures and
their state agencies, the notion that family support is a great way to invest in the future, to promote
the human capital, and to contain escalating social spending.
5) All of the states that are successfully scaling up family support have dealt with volatile
intrusion-into-family issues by ensuring a balance of power between localities and states. None has
left itself open to the charge that the state is dictating to local people how they should raise their
children.
6) Additional research is needed to support the process of planning, implementing, and
scaling up high-quality programs.40
FOCUS ON QUALITY
The 1980s and 1990s have witnessed great progress in the field of family support and parent
education. Concepts that once met wide resistance are now widely embraced by policymakers
and service providers alike. It is now common wisdom in many quarters that, if the prospects
for children are to be enhanced, the focus has to be on at least two and maybe three
generations - on parents and children and grandparents. It is now widely accepted that
parents, to succeed, need communities, not just a service or even a couple of services but a set
of connections that encompass both the public and private sectors.
But these principles, even when they are reflected in planning efforts, mission
statements, and pilot projects, do not always translate into policies or practices that support
and preserve families.41 In fact, in a recent international study, the United States ranked in the
lower half of Western industrialized countries in providing family support services.⁴² This
country is not yet close to systematizing any effort toward comprehensive family support or
parent education. Investments to preserve families remain small.43 And generally speaking,
strengthening families remains low on the nationwide public policy agenda.
The challenges are practical as well as political. Today, services to families and
children, particularly those financed and regulated by the states, remain largely categorical and
fragmented - a patchwork pieced together from the education, health, child welfare, juvenile
justice, and mental health systems. Generally speaking, the fragmented, mainstream service
system does not yet embrace family support principles; those services that do embody family
support principles tend to be add-ons to this mainstream service system. Moreover, the most
31
vulnerable families and the most troubled young people tend to be served by the more
categorical and traditional service systems. Despite rhetoric about family preservation, recent
years have seen an increase in out-of-home placements of children into foster care, mental
health facilities, and juvenile detention and training schools.44
Good practice exists at thousands of family centers and parent support programs across
the country, as well as in agencies and schools that embrace family support principles. But at
this point, family support lacks clear-cut quality standards for program content, performance,
and delivery. Articulating and codifying these standards is an extremely difficult task, because
family support is, by definition, a multifaceted effort that seeks results in several domains at
once: children, family, programs, communities, normative public agencies, and service delivery
systems.45
Efforts are now under way to define and implement quality standards. For example, in
1992 the Family Resource Coalition launched the Best Practices Project, an effort to specify
standards of quality based on the most effective practices of existing community-based family
support programs. This effort mines the knowledge and experience of leading researchers and
practitioners, as well as focus groups, and will digest its findings into user-friendly guidelines
for excellent practice in the field of family support.46 Over the next decade, the challenge is
to follow up on this and other efforts to define quality, by systematically infusing best
practices into new policies and the programs they generate, so that, as a nation, the United
States can move toward high-quality, integrated systems of family support and parent
education.
#
32
ENDNOTES
1. U.S. Bureau of the Census, Economics and Statistics Administration, Statistical Abstract
of the United States, 1994, 114th ed. (U.S. Department of Commerce, 1994).
2. Craig T. Ramey and Sharon Landesman Ramey, "Home Visiting Programs and the
Health and Development of Young Children," The Future of Children, vol. 3, no. 3 (Winter
1993).
3. Sharon L. Kagan and Nancy Cohen, Report of the Quality 2000 Initiative (New Haven:
The Bush Center in Child Development and Social Policy at Yale University,
forthcoming).
4. U.S. Bureau of the Census, Statistical Abstract of the United States, 1994.
5. K. J. Pittman with M. Wright, A Rationale for Enhancing the Role of the Non-School
Voluntary Sector in Youth Development, report prepared for The Carnegie Council on
Adolescent Development Task Force on Youth Development and Community Programs
(Washington, D.C.: Center for Youth Development and Policy Research, Academy for
Educational Development, 1991).
6. U.S. Bureau of the Census, Statistical Abstract of the United States, 1994.
7. Jeanne E. Griffith, The Children of Teenage Mothers, report no. 87-94 EPW (Congressional
Research Service, 1987).
8. Families and Work Institute, Employers, Families, and Education: Facilitating Family
Involvement in Learning (New York, 1994).
9. Sharon L. Kagan, Defining America's Commitments to Parents and Families: An
Historical-Conceptual Perspective (April 1994).
10. Sarah S. Brown, "Preparation for Parenthood," in The Challenge of Parenting in the
Nineties (Washington, D.C.: The Aspen Institute, 1995)
11. Kagan and Cohen, Report of the Quality 2000 Initiative.
12. Arloc Sherman, Wasting America's Future: The Children's Defense Fund Report on the
Costs of Child Poverty (Boston: Beacon Press, 1994).
13. Heather B. Weiss, "Building Villages: Lessons from Policy Entrepreneurs," in Visions of
Entitlement, The Care and Education of America's Children, ed. Mary A. Jensen and Stacie
G. Goffin (Purchase, N.Y.: State University of New York, 1993).
14. Frank Farrow, "Family Support on the Federal Policy Agenda," in Putting Families
First: America's Family Support Movement and the Challenge of Change, ed. Sharon L. Kagan
and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
33
15. Kagan and Cohen, Report of the Quality 2000 Initiative.
16. Heather B. Weiss, "Home Visits: Necessary But Not Sufficient," The Future of Children,
vol. 3, no. 3 (Winter 1993).
17. David Olds, "Promising Preventive Interventions During Pregnancy, Infancy, and Early
Childhood," in The Challenge of Parenting in the Nineties (Washington, D.C.: The Aspen
Institute, 1995).
18. Ibid.
19. Ibid.
20. Ibid.
21. T. Kellaghan et al., "The Effectiveness of Family-Intervention Programs," in Home
Environment and School Learning: Promoting Parental Involvement in the Education of
Children (San Francisco, Ca.: Jossey-Bass, 1993).
22. Norm Fruchter, Anne Galletta, and J. Lynne White, "New Directions in Parent
Involvement," in Equity and Choice, vol. 9, no. 3 (1993).
23. Kagan, Defining America's Commitments to Parents and Families.
24. Fruchter, Galletta, and White, "New Directions in Parent Involvement."
25. Joy G. Dryfoos, Full-Service Schools: A Revolution in Health and Social Services For
Children, Youth, and Families (San Francisco, Ca.: Jossey-Bass, 1994).
26. Sharon L. Kagan, "On Building Parental Competence: The Nature of Contracts and
Commitments," in The Challenge of Parenting in the Nineties (Washington D.C.: The Aspen
Institute, 1995).
27. Robert I. Crowson and William Lowe Boyd, "Coordinated Services for Children:
Designing Arks for Storms and Seas Unknown," in American Journal of Education, vol. 101
(1993).
28. Kathryn Young, "Education for Parenting," paper presented to the Carnegie
Corporation of New York Conference on Scaling Up Family Support and Parent
Education (November 16-17, 1994).
29. Ibid.
30. Dryfoos, Full-Service Schools.
31. Ann Adalist-Estrin, "Family Support and Criminal Justice," in Putting Families First:
America's Family Support Movement and the Challenge of Change, ed. Sharon L. Kagan and
Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
34
32. Cleopatra Howard Caldwell, Angela Dungee Greene, and Andrew Billingsley, "Family
Support Programs in Black Churches: A New Look at Old Functions," in Putting Families
First: America's Family Support Movement and the Challenge of Change, ed. Sharon L. Kagan
and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
33. Families and Work Institute, "Comparative Analysis of Work-Family Programs in
Major Corporations," in The Corporate Reference Guide to Work Family Programs (New
York: Families and Work Institute, 1991).
34. National League of Cities cited in Norman B. Rice, "Local Initiatives in Support of
Families," in Putting Families First: America's Family Support Movement and the Challenge of
Change, ed. Sharon L. Kagan and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass,
1994).
35. Rice, "Local Initiatives in Support of Families."
36. Ibid.
37. Sharon L. Kagan, "Defining and Achieving Quality in Family Support," in Putting
Families First: America's Family Support Movement and the Challenge of Change, ed. Sharon
L. Kagan and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass, 1994).
38. Olds, "Promising Preventive Interventions During Pregnancy, Infancy, and Early
Childhood."
39. Kellaghan et al, "The Effectiveness of Family-Intervention Programs."
40. Weiss, "Building Villages: Lessons from Policy Entrepreneurs."
41. Charles Bruner, "State Government and Family Support: From Marginal to
Mainstream," in Putting Families First: America's Family Support Movement and the Challenge
of Change, ed. Sharon L. Kagan and Bernice Weissbourd (San Francisco, Ca.: Jossey-Bass,
1994).
42. Cited in Camille Sweeney, "Portrait of the American Child, 1995," The New York Times
Magazine (October 9, 1995).
43. Kagan, Defining America's Commitments to Parents and Families.
44. Bruner, "State Government and Family Support."
45. Kagan, "Defining and Achieving Quality in Family Support."
46. Ibid.
35
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Caldwell, Cleopatra Howard, Angela Dungee Greene, and Andrew Billingsley. "Family
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Crowson, Robert I., and William Lowe Boyd. "Coordinated Services for Children: Designing
Arks for Storms and Seas Unknown." American Journal of Education, vol. 101 (1993).
Daro, Deborah, and Richard J. Gelles. "Public Attitudes and Behaviors with Respect to Child
Abuse Prevention." Journal of Interpersonal Violence, vol. 7, no. 4 (1992).
Dryfoos. Joy G. Full-Service Schools: A Revolution in Health and Social Services For Children,
Youth, and Families. San Francisco, Ca.: Jossey-Bass, 1994.
Families and Work Institute. "Comparative Analysis of Work-Family Programs in Major
Corporations." In The Corporate Reference Guide to Work Family Programs. New York:
Families and Work Institute, 1991.
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York: Families and Work Institute, 1994.
Farrow, Frank. "Family Support on the Federal Policy Agenda." In Putting Families First:
America's Family Support Movement and the Challenge of Change. Ed. Sharon L. Kagan and
36
Bernice Weissbourd. San Francisco, Ca.: Jossey-Bass, 1994.
Fruchter, Norm, Anne Galletta, and J. Lynne White. "New Directions in Parent
Involvement." Equity and Choice, vol. 9, no. 3 (1993).
Galinsky, E. and Friedman. Education Before School: Investing In Quality Child Care. New
York: Families and Work Institute, 1993.
Greenawalt, C. E. II. "Educational Outreach Programs." In Educational Innovation: An
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Griffith, Jeanne E. The Children of Teenage Mothers. Congressional Research Service, report no.
87-94 EPW, 1987.
Henderson, Anne T., and Nancy Berla. A New Generation of Evidence: The Family Is Critical
to Student Achievement, 1994.
Kagan, Sharon L. Defining America's Commitments to Parents and Families: An Historical-
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America's Family Support Movement and the Challenge of Change. Ed. Sharon L. Kagan and
Bernice Weissbourd. San Francisco, Ca.: Jossey-Bass, 1994.
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"On Building Parental Competence: The Nature of Contracts and Commitments." In
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Kagan, Sharon L. and Nancy Cohen. Report of the Quality 2000 Initiative. New Haven: The
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39
APPENDIX A
AGENDA
PARENT EDUCATION AND FAMILY SUPPORT: OPPORTUNITIES FOR SCALING UP
November 16-17, 1994
WEDNESDAY, NOVEMBER 16, 1994
PLACE:
Carnegie Corporation of New York
437 Madison Avenue
New York, New York 10022
12:00-1:00 p.m.
Lunch
1:00-1:30 p.m.
Welcome and Overview - David A. Hamburg
2:00-2:30 p.m.
Parent Education and Family Support: Lessons from
Existing Initiatives - Heather Weiss
2:30-3:30 p.m.
Discussion
Moderator:
David A. Hamburg
3:30-3:45 p.m.
Break
3:45-4:15 p.m.
Parent Education and Family Support: Illustrations from
Mainstream Institutions - Kathryn Taaffe Young
4:15-5:15 p.m.
Discussion
Moderator:
David A. Hamburg
6:30-8:30 p.m.
Informal Gathering and Dinner
The New York Palace
The Library and Drawing Room ~ 3rd floor
THURSDAY, NOVEMBER 17, 1994
8:00-8:30 a.m.
Continental Breakfast
8:30-10:30 a.m.
Linking Parent Education and Family Support to the Service
Sectors
Moderator: Vivien Stewart
Child Care
- Lynn Kagan
Education
- Gordon Ambach
Health
- Karen Davis
Welfare
- Gary Stangler
Discussion
10:30-10:45 a.m.
Break
10:45 a.m.-12:30 p.m.
New Opportunities Within Mainstream Institutions
Moderator:
Kathryn Taaffe Young
Churches
- Reverend Carolyn Bullard-Zerweck
- Laura Dean Ford Friedrich
Media
- Larry Kutner
- Ann Pleshette-Murphy
Business
- Betty Southwick
- Deborah Stahl
Discussion
12:30-1:30 p.m.
Lunch
1:30-3:30 p.m.
The Role of Government
Moderator: Michael H. Levine
State
- Con Hogan
- Patrick McCarthy
Federal
- Olivia Golden
- Terry Peterson
Discussion
3:30-4:30 p.m.
Mapping Strategies for Scaling Up Parent Education and
Family Support
Moderator: Vivien Stewart
Judy Jones
4:30 p.m.
Meeting Adjourned
APPENDIX B
LIST OF PARTICIPANTS
Parent Education and Family Support: Opportunities for Scaling Up
November 16-17, 1994
1.
Karen Alexander, Ph.D.
Psychologist
Bush Center in Child Development and Social Policy
Yale University
New Haven, Connecticut
2.
Gordon Ambach
Executive Director, Council of Chief State School Officers
Washington, D.C.
3.
Karen Bell
Associate Director of Child and Family Health
National Center for Children in Poverty
Columbia University
New York, New York
4.
Leslie Mitchel Bond
Director, Healthy Families America
National Committee to Prevent Child Abuse
Chicago, Illinois
5.
The Reverend Carolyn Bullard-Zerweck
Program Associate for Witness and Service
Greater Dallas Community of Churches
Dallas, Texas
6.
Karen Davis, Ph.D.
Executive Vice President, The Commonwealth Fund
New York, New York
7.
Frank Farrow
Director, Children's Services Policy
Center for Study of Social Policy
Washington, D.C.
8.
Laura Dean F. Friedrich, M.Ed.
Director, Church/Community Consultation Services
CHILDSERV
Park Ridge, Illinois
9.
Ellen Galinsky
Co-President, Families and Work Institute
New York, New York
10.
Stacie Goffin, Ed.D.
Senior Specialist
Ewing Marion Kauffman Foundation
Kansas City, MO
11.
Olivia A. Golden, Ph.D., M.A.
Commissioner, Administration on Children, Youth, and Families
United States Department of Health and Human Services
Washington, D.C.
12.
Margaret A. Hamburg, M.D.
Commissioner of Health
New York City Department of Health
New York, New York
13.
Ruby P. Hearn, Ph.D.
Vice President, Robert Wood Johnson Foundation
Princeton, New Jersey
14.
Cornelius Hogan
Secretary, Agency of Human Services
Waterbury, Vermont
15.
Judith E. Jones
Chairperson, Council of Advisors
National Center for Children in Poverty
School of Public Health
Columbia University and
Director of the Free to Grow Program
New York, New York
16.
Sharon Lynn Kagan, Ed.D.
Senior Associate, Bush Center in Child Development
and Social Policy
Yale University
New Haven, Connecticut
17.
Herant Katchadourian, M.D.
Professor, Psychiatry and Behavioral Sciences
Program in Human Biology
Stanford University
Stanford, California
18.
Larry Kutner, Ph.D.
Journalist and Author
New York, New York
19.
Shawn LaFrance
Program Officer, The Commonwealth Fund
New York, New York
20.
Margaret E. Mahoney
President, The Commonwealth Fund
New York, New York
21.
Patrick McCarthy, Ph.D.
Senior Associate, Child and Adolescent Health
The Annie E. Casey Foundation
Baltimore, Maryland
22.
Ann Pleshette Murphy
Editor-in-Chief
Parent Magazine
New York, New York
23.
Barbara Peters
The Partnership Group
New York, New York
24.
Terry K. Peterson, Ph.D.
Counselor to the Secretary
United States Department of Education
Washington, D.C.
25.
Edward Pitt
Director, Male Involvement Project
Families and Work Institute
New York, New York
26.
Gloria G. Rodriguez, Ph.D.
President and Chief Executive Officer
Avance Family Support and Education Program
San Antonio, Texas
27.
Betty J. Southwick
Director of Progam Development
Work/Family Directions
Boston, Massachusetts
28.
Deborah Stahl
Director, Family Care Development Fund
AT&T
Morristown, New Jersey
29.
Gary Stangler
Director, Missouri Department of Social Services
Jefferson City, Missouri
30.
Layla P. Suleiman
Associate Director of Programs
Family Resource Center
Chicago, Illinois
31.
Cathy Trost
Director, The Casey Journalism Center for
Children and Families
College of Journalism
University of Maryland
College Park, Maryland
32.
Heather Weiss, Ed.D.
Director, Harvard Family Research Project
Graduate School of Education
Harvard University
Cambridge, Massachusetts
33.
Susan N. Wilson
Executive Director, Network for Family Life Education
Center for Social and Community Development
Rutgers University
New Brunswick, New Jersey
34.
Mildred M. Winter
Executive Director
Parents As Teachers National Center, Inc.
St. Louis, Missouri
~
Carnegie Corporation of New York Staff
1.
David A. Hamburg, President
2.
Barbara D. Finberg, Executive Vice President
and Program Chair, Special Projects Committee
3.
Vivien Stewart, Senior Advisor to the President and
Program Chair, Education and Healthy Develpment of Children and Youth
4.
Michael H. Levine, Program Officer
Education and Healthy Development of Children and Youth
5.
Gloria Primm Brown, Program Officer
Education and Healthy Development of Children and Youth
6.
Karin P. Egan, Program Officer
Education and Healthy Development of Children and Youth
7.
Anthony W. Jackson, Program Officer
Education and Healthy Development of Children and Youth
8.
Kathryn Taaffe Young, Director of Studies
Task Force on Meeting the Needs of Young Children
9.
Antony Ward, Executive Director
Task Force on Learning in the Primary Grades
10.
Fred M. Hechinger, Senior Advisor
11.
Susan V. Smith, Program Associate
Education and Healthy Development of Children and Youth
12.
Nidia Marti, Administrative Assistant
Education and Healthy Development of Children and Youth
13.
Bonnie J. Piller, Secretary
Task Force on Meeting the Needs of Young Children
14.
Kathleen Sheridan, Secretary
Education and Healthy Development of Children and Youth
~
Rapporteur
15.
Rima Shore
Brooklyn, New York
~
Meeting Reporter
16.
Victoria McLaughlin
Miller Reporting