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Many factors influence the health and well-being of children and the adults they will become. Yet there are significant gaps in how trajectories of healthy development are measured, how the potential for leading a healthy life is evaluated, and how that information can guide upstream policies and investments. The Gross Developmental Potential (GDP2) is proposed as a new capabilities-based framework for assessing threats to thriving and understanding progress in achieving lifelong health and wellbeing. Moving beyond the Gross Domestic Product’s (GDP) focus on economic productivity as a measure of progress, the GDP2 focuses on seven essential developmental capabilities for lifelong health and wellbeing. The GDP2 capability domains include Health -living a healthy life; Needs-satisfying basic human requirements; Communication-expressing and understanding thoughts and feelings; Learning-lifelong learning; Adaption -adapting to change; Connections -connecting with others; and Community -engaging in the community. The project team utilized literature reviews and meetings with the subject and technical experts to develop the framework. The framework was then vetted in focus groups of community leaders from three diverse settings. The community leaders' input refined the domains and their applications. This prototype GDP2 framework will next be used to develop specific measures and indices and guide the development of community-level GDP2 dashboards for local sense-making, learning, and application.

In this article, M. Rebecca Kilburn and Jill S. Cannon report on First Born, a targeted universal home visiting program operating in over half of New Mexico counties. Created in a small town in response to a lack of support for pregnant women and new parents, First Born adapts features of other home visiting programs, responding to conditions common to high-need, low-resource communities. As its name suggests, First Born enrolls first-time families. A team of home visitors, including a registered nurse or other licensed health care professional and a paraprofessional parent educator, offers 40 weekly home visits during the child's first year; the frequency of visits diminishes during the child's second and third year. The nurse visits the home both before and after the child's birth, and also when medical issues are the focus of visit. Because nurses are in short supply in many communities, however, most of the home visits are made by parent educators, who coordinate with the nurse visitor. To promote early childhood health and development, First Born educates parents and helps them access community resources, using a three-pronged approach: helping the family to develop life and social skills, such as decision-making, crisis intervention, and knowledge of child development; using screening tools to identify problems (for example, substance dependency or developmental delays) and referring families to the appropriate sources of help; and promoting effective coordination among community resources. Based on First Born's scale-up experience, Kilburn and Cannon outline several lessons for other universal programs, including the pros and cons of universal services, the expectation that universal programs will have population-level impact, and barriers to innovation.

Problematic rates of alcohol, e-cigarette, and other drug use among US adolescents highlight the need for effective implementation of evidence-based programs (EBPs), yet schools and community organizations have great difficulty implementing and sustaining EBPs. Although a growing number of studies show that implementation support interventions can improve EBP implementation, the literature on how to improve sustainability through implementation support is limited. This randomized controlled trial advances the literature by testing the effects of one such implementation intervention—Getting To Outcomes (GTO)—on sustainability of CHOICE, an after-school EBP for preventing substance use among middle-school students. CHOICE implementation was tracked for 2 years after GTO support ended across 29 Boys and Girls Club sites in the greater Los Angeles area. Predictors of sustainability were identified for a set of key tasks targeted by the GTO approach (e.g., goal setting, evaluation, collectively called “GTO performance”) and for CHOICE fidelity using a series of path models. One year after GTO support ended, we found no differences between GTO and control sites on CHOICE fidelity. GTO performance was also similar between groups; however, GTO sites were superior in conducting evaluation. Better GTO performance predicted better CHOICE fidelity. Two years after GTO support ended, GTO sites were significantly more likely to sustain CHOICE implementation when compared with control sites. This study suggests that using an implementation support intervention like GTO can help low-resource settings continue to sustain their EBP implementation to help them get the most out of their investment. ClinicalTrials.gov Identifier: NCT02135991.

Implementation support interventions have helped organizations implement programs with quality and obtain intended outcomes. For example, a recent randomized controlled trial called Preparing to Run Effective Programs (PREP) showed that an implementation support intervention called Getting To Outcomes (GTO) improved implementation of an evidence-based substance use prevention program (CHOICE) run in community-based settings. However, more information is needed on how these interventions affect organizational barriers and facilitators of implementation. This paper aims to identify differences in implementation facilitators and barriers in sites conducting a substance use prevention program with and without GTO. PREP is a cluster-randomized controlled trial testing GTO, a two-year implementation support intervention, in Boys & Girls Clubs. The trial compares 15 Boys & Girls Club sites implementing CHOICE (control group), a five-session evidence-based alcohol and drug prevention program, with 14 Boys & Girls Club sites implementing CHOICE supported by GTO (intervention group). All sites received CHOICE training. Intervention sites also received GTO manuals, training, and onsite technical assistance to help practitioners complete implementation best practices specified by GTO (i.e., GTO steps). During the first year, technical assistance providers helped the intervention group adopt, plan, and deliver CHOICE, and then evaluate and make quality improvements to CHOICE implementation using feedback reports summarizing their data. Following the second year of CHOICE and GTO implementation, all sites participated in semi-structured interviews to identify barriers and facilitators to CHOICE implementation using the Consolidated Framework for Implementation Research (CFIR). This paper assesses the extent to which these facilitators and barriers differed between intervention and control group. Intervention sites had significantly higher average ratings than control sites for two constructs from the CFIR process domain: planning and reflecting and evaluating. At the same time, intervention sites had significantly lower ratings on the culture and available resources constructs. Findings suggest that strong planning, evaluation, and reflection—likely improved with GTO support—can facilitate implementation even in the face of perceptions of a less desirable implementation climate. These findings highlight that implementation support, such as GTO, is likely to help low-resourced community-based organizations improve program delivery through a focus on implementation processes.Trial RegistrationThis project is registered at ClinicalTrials.gov with number NCT02135991 (URL: https://clinicaltrials.gov/show/NCT02135991). The trial was first registered May 12, 2014.

A significant and growing English learner (EL) population attends public schools in the United States. Evidence suggests they are at a disadvantage when entering school and their achievement lags behind non-EL students. Some educators have promoted full-day kindergarten programs as especially helpful for EL students. We take advantage of the large EL population and variation in full-day kindergarten implementation in the Los Angeles Unified School District to examine the impact of full-day kindergarten on academic achievement, retention, and English language fluency using difference-in-differences models. We do not find signficant effects of full-day kindergarten on most academic outcomes and English fluency through second grade. However, we find that EL students attending full-day kindergarten were 5 percentage points less likely to be retained before second grade and there are differential effects for several outcomes by student and school characteristics.

Kindergarten policy varies widely both across and within states. Over the past decade, a number of states have instituted a full-day kindergarten requirement and others are considering it as a way to increase educational achievement. Many parents also support full-day kindergarten as a source of child care. This paper uses the Early Child Longitudinal Study-Kindergarten Class of 1998-1999 to evaluate the efficacy of this policy. In ordinary least squares, probit, county fixed effects, and instrumental variables models, we find that there are initial benefits for students and the mothers of students who attend full-day kindergarten, but that these differences largely evaporate by third grade. Contrary to claims by some advocates, attending full-day kindergarten is found to have no additional benefit for students in families with income below the poverty threshold.

Considers the potential consequences of not investing additional resources in children's lives, the range of early intervention programs, the demonstrated benefits of interventions having high-quality evaluations, the features associated with successful programs, and the returns to society associated with investing early in the lives of disadvantaged children. The findings indicate the existence of a body of sound research that can guide resource allocation decisions.

Growth in federal, state, and private funding is fueling the initiation of home visiting programs around the country. As communities expand home visiting programs, they need information to help them successfully start up new sites. This paper documents lessons learned about home visiting installation and initial implementation from the replication of the First Born ® Program in six counties in New Mexico. Specifically, we examine how well sites met staffing, family referral and enrollment, program model fidelity, and financing goals in the first year of providing services. Data come from semi-structured interviews with program staff and document review. The findings are likely to be valuable to a wide spectrum of communities starting or expanding home visiting services, as well as to public and private funders of programs.

With the growing push toward accountability and the interest in designing programs based on scientific evidence, decision makers increasingly need to know what works in the social policy arena. This need has fueled a proliferation of projects aimed at compiling best practices. These projects can be approached in numerous ways, which differ according to their target audience, philosophy regarding what constitutes evidence, medium of presentation, and a host of other factors. One such project is the Promising Practices Network (PPN) on Children, Families, and Communities. The motivation behind the approach to providing information about what works is explained. The focus of PPN is to provide high-quality objective evidence about what improves outcomes for children and families, with an emphasis on serving [policy-makers and service providers. For policymakers and service providers who would like to adopt a program and replicate it in their community, more information is needed about the issues involved with scaling up and replicating a program.

Drawing on national, state, and local data, the Urban Child Institute partnered with RAND to explore the social and emotional well-being of children in Memphis and Shelby County, Tenn. The book highlights the importance of factors in the home, child care setting, and community that contribute to social and emotional development.