Start Program Research Articles

Researchers, Head Start programs address maternal depression

An online program developed by researchers at Georgia State University and the Oregon Research Institute aims to help low‐income mothers struggling with depression. Designed with input from Head Start mothers and staff, the program is being disseminated in Head Start programs throughout the country.

Height and Weight Measurement and Communication With Families in Head Start: Developing a Toolkit and Establishing Best Practices.

Background: Head start (HS) programs are required to collect children's height and weight data. Programs also communicate these results to families. However, no standardized protocol exists to guide measurements or communicate results. The purpose of this article was to describe the development of a measurement toolkit and best practices for communication. Methods: HS programs contributed to the development and pilot testing of a toolkit for HS staff to guide child measurement. We used a three-phase iterative approach and qualitative methods to develop and test the toolkit, which included a video and handout. In addition, we convened an advisory group to draft best practices for communication. Results: HS program staff appreciated the toolkit materials for their simplicity and content. The advisory group highlighted the importance of weight stigma and the need to be cautious in the way that information is communicated to families. The group underscored the role of emphasizing health behavior change, instead of focusing solely on BMI. Best practices were organized into (1) Policies and procedures for communicating screening results, (2) training for HS program staff to improve communication related to screening and health behaviors, and (3) other best practices to promote health behaviors and coordinate data systems. Conclusions: Our toolkit can improve anthropometric measurements of HS to ensure that potential surveillance data are accurate. Advisory group best practices highlight opportunities for HS to develop and implement policies, procedures, and trainings across the country to improve communication with HS families. Future research should test the implementation of these best practices within HS.

Mindfulness Intervention with African-American Caregivers at a Head Start Program: An Acceptability and Feasibility Study

Mindfulness Intervention with African-American Caregivers at a Head Start Program: An Acceptability and Feasibility Study

Causes of Low Communicative Competences in English as a Foreign Language: Considerations and Reflections

Mastering English as a lingua franca has become a first-rate skill for new professionals in most jobs around the world. According to the bilingualism policies in Colombia it is expected that students from higher education achieve a level of English between B1 or B2 according to the Common European Framework of Reference for Languages (CEFRL), with students from bachelor degree programs in foreign languages, the level must be C1, in this sense the Ministry of Education has implemented projects and strategies to get a bilingual professional with high communicative competences, according to the demands of the globalized world. However, most students show low levels of communicative proficiency in English according to the results of the test applied by ICFES. Despite the demands of learning English, weaknesses persist in the mastery of communicative competences. A constant concern is to investigate some causes of low communication skills in this language. This article presents the results of some research conducted in various countries around the world that has attempted to investigate these causes. The causes, according to the results of the research, have to do with social and cultural aspects, but more importantly, teacher performance is one of the most frequent causes. This requires special attention to start programs and projects aimed at training teachers in didactic competencies.

Breastfeeding Intentions among Pregnant Women Enrolled in a Healthy Start Program in Arkansas.

Exclusive breastfeeding is recognized as the optimal source of nutrition for infants. Although exclusive breastfeeding rates have increased overall in the United States, substantial inequities exist in breastfeeding among individuals of different socioeconomic statuses, races, and ethnicities. The purpose of this study was to examine characteristics associated with exclusive breastfeeding intentions among pregnant women in Arkansas enrolled in a Healthy Start program. The current study included a cross-sectional design, with a sample of 242 pregnant women in Arkansas enrolled in a Healthy Start program. The majority of the participants (56.6%) indicated their infant feeding intentions included a combination of breastfeeding and formula feeding. There were substantial differences in breastfeeding intentions among women of different races/ethnicities, with 18.5% of Marshallese women indicating they planned to exclusively breastfeed, compared to 42.1% of White women, 47.6% of Black women, and 31.8% of Hispanic women (p < 0.001). Women over the age of 18 and with higher educational attainment were more likely to intend on exclusively breastfeeding. This is the first study to examine characteristics associated with exclusive breastfeeding intentions among pregnant women in Arkansas enrolled in a Healthy Start program. The study found that race/ethnicity and age were most strongly associated with breastfeeding intentions. These findings are critical to identifying populations for resource allocation and to developing culturally-tailored interventions to help women in Arkansas achieve their desired infant feeding methods.

Program director longevity in emergency medicine residencies: A 40-year analysis.

We sought to assess trends in emergency medicine residency program director (PD) length of service over the past 40 years and evaluate relationships between duration of service and important factors such as PD start year, geographic region, and year of program initial accreditation. We retrospectively analyzed program data from the American Medical Association Graduate Medical Education Directory and Emergency Medicine Residents' Association Match database. We calculated descriptive statistics and used linear regression to assess the impact of PD start year, region, and year of program initial accreditation on PD duration of service. We gathered data on 783 unique PDs between 1983 and 2023. The overall mean ± SD PD duration of service was 6.19 ± 4.72 years (range 1-29 years). The mean duration of service by decade of start date was 6.49 years in the 1980s, 7.39 years in the 1990s, 5.92 years in the 2000s, 4.08 years in the 2010s, and 2 years in the 2020s. Both PD start year (p = 0.002) and program initial accreditation year (p = 0.001) significantly predicted duration of PD service. Region did not significantly predict duration of PD service (p = 0.225). Duration of service as a PD is decreasing in recent decades. Both PD start year and year of initial program accreditation significantly predict duration of service as PD. Future research must be done to better understand this phenomenon and uncover strategies to promote PD longevity.

Better start to better future? Long-term follow-up of a parenting intervention for mothers being released from incarceration

Abstract Objectives This study examined the long-term effects of the Better Start program, an adaptation of Incredible Years parent training enhanced with home visits, for families with mothers being released from incarceration. Methods Participants in this quasi-experimental longitudinal study were 224 mothers, of whom 145 (64.7%) received intervention and the other mothers constituted a no intervention group. Official criminal justice records and mother reports of parenting behaviors and child behavior were collected up to 10 years after intervention. Mixed effects models, Cox regression analyses, and latent linear growth models were used to test potential intervention effects on adolescent delinquency, maternal recidivism, parenting behaviors, and disruptive child behaviors. Results Outcomes favoring participants in the intervention condition were found for adolescent delinquency, maternal recidivism, and the number of disruptive child behaviors. Conclusions Effects on maternal recidivism and delinquency in their children indicate that the Better Start program contributes to preventing the intergenerational transmission of delinquency.

Profiles of home language experiences of Spanish-English dual language learners in migrant and seasonal head start programs

Children from migrant and seasonal farmworker (MSFW) families are among the most educationally disadvantaged and underserved groups in the United States; however, they have received limited research attention. Using a large nationally representative sample of MSFW children in Migrant and Seasonal Head Start (MSHS) programs, this study offered national portraits of MSHS Spanish-English speaking children's language experience profiles in their homes. Preschool-aged Spanish-English dual language learners (DLLs; N = 280) were classified into two distinct profiles: (1) the Bilingual Exposure group (58.9%), comprising DLLs who had Spanish-English exposure from both adults and children, and (2) the Adult-Spanish, Child-Bilingual Exposure group (41.1%), consisting of DLLs who had Spanish-dominant exposure from adults and exposure to both languages from other children. Compared to the Adult-Spanish, Child-Bilingual Exposure group, children in the Bilingual Exposure group were more likely to come from non-immigrant families, had mothers with higher educational levels, and engaged in more home learning activities. When literacy skills were compared, the Adult-Spanish, Child-Bilingual Exposure group presented higher Spanish letter-word identification skills than the Bilingual Exposure group. No group differences were found in English letter-word identification and bilingual auditory comprehension. Our findings suggest the importance of Spanish language experience at home and call for tailoring educational approaches that consider the diverse home experiences of DLLs attending MSHS.

Barriers to health care and pregnancy experiences in relation to Black, low-income mothers' perinatal attachment and depression.

The goal of this study was to examine whether barriers to accessing health care and negative pregnancy experiences would predict depressive symptomatology and attachment to their neonates among Black mothers from low-income backgrounds across the perinatal period. We were also interested in examining whether these mothers' engagement in prenatal health practices would buffer against their pregnancy experiences to promote positive postnatal maternal functioning. Participants were 118 Black pregnant women from low-income backgrounds, recruited from WIC and Early Head Start programs. A prenatal assessment between 28 and 40 weeks gestation measured pregnancy experiences and prenatal health practices, and a postnatal assessment about 4 weeks postpartum measured maternal functioning in the form of depressive symptoms and attachment to their neonates. Linear regressions with prenatal health practices included as a moderator suggested that while engaging in positive health practices during pregnancy could potentially buffer against negative pregnancy experiences and prenatal depressive symptoms, it is unlikely to buffer against barriers to accessing health care. These results imply the need to provide support for accessing health care among pregnant women to address disparities in the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

UCI EyeMobile Exam Findings from School Children Following on-Site Screening.

Uncorrected refractive errors (REs) and amblyopia can lead to visual impairment with deleterious effects on quality of life and academic performance. Early detection and treatment by community vision care programs, such as the UCI EyeMobile for Children, can aid in addressing preventable vision loss. A total of 5074 children between the ages of 3 and 10 years were screened at 153 locations, including preschools, head start programs, and elementary schools within Orange County (OC), California (CA). Subsequently, 1024 children presented for comprehensive eye examinations. A retrospective analysis of all examined children was conducted, determining the frequency and severity of REs and amblyopia and the spectacle prescription rate by age. Propensity score matching analysis evaluated the effect of median household income on RE and amblyopia frequency. Among those who failed initial screening and were subsequently examined, significant rates of REs and amblyopia were detected: myopia (24.4%), hyperopia (35.4%), astigmatism (71.8%), anisometropia (8.9%), amblyopia (7.0%), and amblyopia risk (14.4%). A majority (65.0%) of those examined received prescription spectacles from UCI EyeMobile, with around a third requiring a new or updated prescription. The frequency of REs and amblyopia and the spectacle prescription rate were uniform across OC congressional districts. Myopia and amblyopia risk was positively and negatively associated with household income, respectively. The UCI EyeMobile for Children serves as a vital vision care program, providing free vision screening, comprehensive eye examinations, and spectacles. A significant number of children required examination, and a high frequency of REs and amblyopia were detected in examined children, with subsequent provision of prescription spectacles to most children.

사회 정의 관점에서의 아동 교육복지 정책 분석

[Purpose] This study investigates educational welfare policies to address the widening educational disparities among low-income children and adolescents under increasing social polarization. It focuses on analyzing the enactment of social justice in the Head Start program in the USA, Sure Start in the UK, and Dream Start in South Korea.&#x0D; [Methods] Employing Gewirtz and Cribb's(2002) plural models of social justice, an extension of John Rawls' theory of distributive justice, this study examines the threefold aspects of 'distributive, cultural, and organizational justice' in these policies.&#x0D; [Results] Key findings highlight that these policies variously achieve distributive, cultural, and organizational justice through effective resource allocation, information accessibility, recognition of beneficiary diversity, and democratic participation. Specific emphasis is placed on the need for equitable information distribution in distributive justice, acknowledgment of diversity in cultural justice, and democratic stakeholder participation in organizational justice.&#x0D; [Conclusion] The study underscores the necessity of exploring how these justice dimensions interact and coexist, proposing policy recommendations for the future trajectory of child education welfare.

Evaluating integrated maternity care policies with causal inference methods and routine-collected observational data

Background: Two integrated maternity care policies implemented in the Netherlands in recent years have been continuously evaluated to create a learning evaluation as part of the implementation process.&#x0D; Methods: In this presentation, we will zoom in on the quasi-experimental methods we use for the evaluation of integrated maternity care policies. This evaluation targets involved disciplines, e.g. care providers in the medical and social domain, policy makers and patients. The integrated maternity care organizations were involved in the design of the learning evaluation.&#x0D; Difference-in-differences is an often used quasi-experimental design, derived from economic evaluations, and well-suited for policy evaluations.[1] When carefully modelling the treatment and control group, effects of the integrated care policies can be evaluated with difference-in-differences based on observational data.[2] &#x0D; In the Netherlands, we created an anonymized data-infrastructure focused on maternity care and early life. This data-infrastructure contains nation-wide, routine-collected observational data from electronic health records, claims data and background characteristics linked on an individual level. We use this data-infrastructure in the evaluation of integrated maternity care policies with difference-in-differences that controls for unobservable confounding variables, e.g. level of collaboration in maternity care regions.&#x0D; We used this data-infrastructure to evaluate bundled payments in maternity care. This policy was implemented in 2017 on an experimental and voluntary basis to enhance integrated care between the different maternity care providers. Difference-in-difference analysis was used to evaluate the effects of bundled payments on child and maternal outcomes and healthcare costs. Furthermore, we evaluated the promising start program that aims to improve the first 1000 days of every child, in particular of vulnerable pregnancies, by increasing collaboration between both the medical and social domain.&#x0D; Results: We will describe the process of creating our national-level observational data-infrastructure and its contents. Secondly, we will indicate how similar processes could be initiated in other countries and other areas of healthcare. We will then discuss in more detail how we evaluated the two integrated maternity care policy interventions: bundled payments and the promising start program; and present preliminary results of these evaluations. For example, in the evaluation of bundled payments, we found integrated maternity care organizations (intervention group) reached cost savings compared to organizations without integrated care contracts and bundled payments (control group). We will discuss our findings from these evaluations in more detail as an illustration for other integrated care policy evaluations using observational data. &#x0D; Conclusion: Opportunities and limitations of a nationwide, observational data-infrastructure to evaluate integrated care policies via causal inference methods will be shared and discussed with the audience. Next to this, we will discuss and summarize several lessons learned and challenges that we encountered during the evaluations of integrated care policies. Additionally, we will also touch on the added value and possibilities to integrate qualitative research in interpreting the quantitative data and outcomes based on observational data. &#x0D; [1] Hernán MA. Methods of Public Health Research - Strengthening Causal Inference from Observational Data. N Engl J Med. 2021;385(15):1345-8&#x0D; [2] Angrist J, Pischke JS. Princeton University Press; Princeton: 2009. Mostly Harmless Econometrics: An Empiricist’s Companion.

Promising Practices to Promote Physical Activity and Healthy Eating Among Head Start Caregivers and Their Children

Many children in Head Start programs do not meet physical activity (PA) and dietary intake recommendations and have increased risk for obesity. The purpose of this pilot study was to formatively assess a multi-level intervention, exploring strategies to encourage PA and healthy eating among north Texas Head Start families. In year 1, 5 Head Start sites with 217 children began the Head Start to Healthy Lifestyles (HSHL) project. Direct and indirect education strategies began in the last 2 months of the school year. Surveys were used to evaluate child and caregiver PA, healthy eating behaviors, and interagency collaboration. Strategies and barriers to adopting healthy lifestyles were assessed via grant partner discussions. Of 217 children enrolled, 109 caregivers consented to participate in research, of which 35 completed baseline surveys and 10 also submitted post surveys. The number of fruits eaten by Head Start caregivers improved ( P &lt; .05). Perceived level of collaboration among grant partners was high. Strategies appreciated by Head Start site partners included PA support in the classrooms, take-home gardens, and reading food group books. Additional needed support included tasting and on-site cooking classes. Barriers to participation included few face-to-face meetings with parents, staffing shortages post-COVID, and difficulty engaging families.

Teaching staff are often exposed to stressors. Stress as a state of emotional imbalance reduces work efficiency and makes the person more vulnerable to challenges. The teachers’ view of stress is one of a state of imbalance, tension. Workplace stressors such as overwork, overtime, as well as the lack of clear goals of the institution, poor communication between colleagues lead

Teaching staff are often exposed to stressors. Stress as a state of emotional imbalance reduces work efficiency and makes the person more vulnerable to challenges. The teachers’ view of stress is one of a state of imbalance, tension. Workplace stressors such as overwork, overtime, as well as the lack of clear goals of the institution, poor communication between colleagues lead to physical and social isolation of the person. The development of an anti-stress code through the needs of affiliation, security, the novelty of the experience, the relaxations methods, as well as the involvement in the NEW–START program are obvious premises in this context.

Racial Disparities in the Impact of Head Start on Health Outcomes Among Low-Income Head Start-Eligible Children and Parents.

This study examined racial disparities in Head Start's impact on health outcomes for families with young children in poverty. Research questions were as follows: (a) are there racial disparities in health outcomes among low-income families? (b) Does Head Start participation promote better health outcomes? And (c) does Head Start's impact on health outcomes differ by race and ethnicity? Logistic regression analysis found that African American and Hispanic children experience lower health outcomes than their white peers, including lower rates of dental screening, more frequent injury-related care, lower overall health status, and lower rates of health insurance coverage. In comparison to White parents, African American and Hispanic parents reported lower levels of cigarette smoking. Children enrolled in Head Start received significantly more dental screening than their non-Head Start peers, regardless of race and ethnicity. The positive impacts of Head Start were particularly pronounced for African American and Hispanic children when compared to White children. Families that do not speak English as their primary language and those with lower household incomes experienced worse health outcomes. The positive impact of Head Start on the health outcomes of marginalized populations highlights the need for continued expansion of Head Start programs, as they strive to provide equal opportunities for improvements in academic, socio-emotional, and health outcomes for children and their parents in low-income households. The recruitment and enrollment process for Head Start should provide eligibility and application information in multiple languages for families in deep poverty.

A Scientometric Analysis of the Use Indices for Water Quality Biomonitoring

Water resources are supplied under strong anthropic pressures and result in several problems of water contamination in the world, which necessitates the use of methodologies for their evaluation. Thus, this research aimed to identify the biomonitoring indices based on macroinvertebrates in the evaluation of the quality of the water used and to identify its application trends. The study was developed through a scientometric review over a 20-year period (2000–2020). The search consisted of articles indexed in the Scielo, ScienceDirect, and Scopus databases, based on the keywords “biotic index” * OR “aquatic macroinvertebrates” * OR “benthic macroinvertebrates” * OR “Biomonitoring” * AND “water quality.” Selection, such as inclusion and exclusion, was applied in the Start program (State of the Art through Systematic Review-Start). The results showed that the EPT index (Ephemeroptera, Plecoptera, and Trichoptera) was the most used among all researched databases (20%), and among the Ecological Indicators journals from which the largest number of publications were obtained (11%). Regarding the indices used in biomonitoring research, the ASPT index (average score per taxon) was the only one with a tendency to increase in use over the years (R² = 0.29; p &lt; 0.05). Although the biomonitoring indices are commonly used worldwide denoting that it is still an alternative tool, this literature review showed that among the indices only one has a trend of use, which must be considered for further research.

A baseline assessment of developmental delays among children under 5 years in a high-HIV- prevalence setting in the Cape Metropole

&#x0D; &#x0D; &#x0D; &#x0D; Background. More than 200 million children globally are at risk of not achieving the full developmental potential owing to multiple factors. HIV exposure is of particular concern as evidence suggests that children born to mothers who are HIV-positive are likely to experience developmental delays. Furthermore, the psychosocial and economic impacts of HIV, such as parental illness, poor mental health, poverty and malnutrition, also affect children’s development.&#x0D; Objective. To assess and address the developmental challenges faced by children aged 2 - 5 years living in high-HIV prevalence settings through a toy-based rehabilitation intervention and to analyse the prevalence and nature of developmental delays observed in these children using the Ages and Stages Questionnaires (ASQ-3).&#x0D; Methods. In response, the Bright Start programme was developed and implemented to target children living in high HIV-prevalence settings. In 2019, a pilot project was implemented with 90 caregiver-child dyads in Cape Town, South Africa. A baseline survey was conducted to assess developmental progression for all the children (N=141) in the care of the 90 caregivers using the Ages and Stages Questionnaires (ASQ-3) for children aged 24, 36, 48 and 60 months.&#x0D; Results. Findings showed that 64% of children had delays in at least one domain and 37% had multiple delays. More than half of the children had developmental delays in fine motor skills (51%), while gross-motor and problem-solving delays were reported for 30% and 26% of children, respectively. Communication and personal-social domain delays were observed in 17% and 14% of children, respectively.&#x0D; Conclusion. The prevalence of developmental delays among children in the programme was alarmingly high. These findings indicate that developmental delay is a serious concern for children living in high-HIV-prevalence settings. Early identification and timeous referrals of children with developmental delays are critical and may enable children to reach their full developmental potential.&#x0D; &#x0D; &#x0D; &#x0D;

Effects of family and neighborhood vulnerability on dual language learner and monolingual children’s preschool outcomes

IntroductionResearch has documented that home and neighborhood contexts of children from low-income families are associated with lower cognitive and social–emotional skills than their higher-income peers. Even though over a third of young children growing up in poverty are dual language learners (DLLs), little research has examined how contextual effects differ between DLL and monolingual children. The current study examines how these two contexts, neighborhood vulnerability and family socioeconomic risk, impact executive function (EF) and social–emotional skills in DLL and monolingual preschoolers.MethodsA secondary analysis was completed on data from two Head Start programs. A series of cross-classified models with interactions were conducted to examine the moderating role of DLL status on associations between neighborhood vulnerability and family risk and preschoolers’ EF and social-emotional skills.ResultsProficient bilingual children’s EF skills were not impacted by neighborhood risks, suggesting that proficient bilingual children may have more opportunities to grow their EF skills when switching between English and Spanish regardless of neighborhood context. An unexpected result occurred for emergent bilingual children who were reported to demonstrate fewer behavior problems regardless of family risk, highlighting the importance of ensuring all DLL families have access to resources to promote their children’s social–emotional skills; and teachers have the proper training to support the behaviors of children in their classroom with varying levels of English proficiency.DiscussionAlthough speaking two languages may be a protective factor for young DLLs growing up in poverty, little research has examined how contextual effects differ between DLL and monolingual children. The current study contributes by examining how DLL status, especially two different DLL statuses (i.e., Proficient Bilinguals and Emergent Bilinguals), may vary as a buffer in moderating the negative associations between collective neighborhood vulnerability, individual family risk, and children’s EF and social–emotional skills.

Head Start Funding Expansions and Program Inputs

This paper provides some of the first evidence on the relationship between Head Start funding expansions and program inputs. We take advantage of the county–year variation in funding increases that were implemented due to a number of legislated policy changes in the late 1980s and throughout the 1990s. By focusing on the period between 1988 and 2007, we show that the funding increases were directed at increasing total and full-time enrollment. We also show that the funding expansions were used to make several quality-related investments, including increasing the number of teachers and staff and upgrading the skill level of teachers.

The Dutch Solid Start program: describing the implementation and experiences of the program's first thousand days

BackgroundIn 2018, the Dutch government initiated the Solid Start program to provide each child the best start in life. The program focuses on the crucial first thousand days of life, which span from preconception to a child’s second birthday, and has a specific focus towards (future) parents and young children in vulnerable situations. A key program element is improving collaboration between the medical and social sector by creating Solid Start coalitions. This study aimed to describe the implementation of the Dutch Solid Start program, in order to learn for future practice and policy. Specifically, this paper describes to what extent Solid Start is implemented within municipalities and outlines stakeholders’ experiences with the implementation of Solid Start and the associated cross-sectoral collaboration.MethodsQuantitative and qualitative data were collected from 2019 until 2021. Questionnaires were sent to all 352 Dutch municipalities and analyzed using descriptive statistics. Qualitative data were obtained through focus group discussions(n = 6) and semi-structured interviews(n = 19) with representatives of care and support organizations, knowledge institutes and professional associations, Solid Start project leaders, advisors, municipal officials, researchers, clients and experts-by-experience. Qualitative data were analyzed using the Rainbow Model of Integrated Care.ResultsFindings indicated progress in the development of Solid Start coalitions(n = 40 in 2019, n = 140 in 2021), and an increase in cross-sectoral collaboration. According to the stakeholders, initiating Solid Start increased the sense of urgency concerning the importance of the first thousand days and stimulated professionals from various backgrounds to get to know each other, resulting in more collaborative agreements on cross-sectoral care provision. Important elements mentioned for effective collaboration within coalitions were an active coordinator as driving force, and a shared societal goal. However, stakeholders experienced that Solid Start is not yet fully incorporated into all professionals’ everyday practice. Most common barriers for collaboration related to systemic integration at macro-level, including limited resources and collaboration-inhibiting regulations. Stakeholders emphasized the importance of ensuring Solid Start and mentioned various needs, including sustainable funding, supportive regulations, responsiveness to stakeholders’ needs, ongoing knowledge development, and client involvement.ConclusionSolid Start, as a national program with strong local focus, has led to various incremental changes that supported cross-sectoral collaboration to improve care during the first thousand days, without major transformations of systemic structures. However, to ensure the program’s sustainability, needs such as sustainable funding should be addressed.