Funded Projects

The ENABLE Kids Project

Project Year

2024

City & State

Greenville, North Carolina

Program Name

CATCH Planning

Topic

School Readiness/Head Start

Program Description

Background: Social determinants of health (SDoH) profoundly influence children’s health and development. Among preschool-age children, participation in early childhood education (ECE) provides immediate benefits to social and emotional development and kindergarten readiness, and is associated with a multitude of advantages in educational attainment, employment, and social relationships later in the life course. Access to high quality ECE programs, especially for children at highest risk for economic and social disadvantage, is necessary to promote school attainment, reduce childhood poverty and promote health into adulthood. Accordingly, increasing the proportion of children who participate in high quality ECE programs is a cornerstone of the Healthy People 2030 objectives set by the US Department of Health and Human Services (HHS), and this focus on ECE access is intended to eliminate health disparities, achieve health equity, and improve the health and well-being of all people in the United States .1 Similarly, in 2019, the North Carolina Early Childhood Education plan, a framework  aiming to improve whole person outcomes from birth to age 8, has set a goal to have at least 3/4ths of children in NC participate in ECE programs.2  Among at-risk children, participation in a high quality ECE program leads to higher achievement in math and reading, lower risk of grade retention, and higher graduation rates.3-6 This increase in educational performance can contribute to improved health outcomes well into adulthood.7-9 Currently, 51% of eligible children in NC are enrolled in a pre-K program,10,11 but only 23% of NC children living in poverty are enrolled in a Head Start program, and only 3% are enrolled in Early Head Start.12  Multiple barriers can hinder enrollment in ECE programs. Current systems of delivering ECE programming focus on the caretakers’ role in enrolling their eligible children, but some eligibility requirements can be difficult for families to understand, and other families may not be aware of these programs until the program is already at capacity, leaving no room for their children to enroll. The American Academy of Pediatrics (AAP) recommends that all children be seen by their primary care provider a total of 12 times in the first 3 years of their life for routine preventive care, and 2 additional times by 5 years of age. As children are seen by their primary care provider so frequently in the first 5 years of life, providers in the child’s medical home are uniquely positioned to identify children who are eligible for ECE programs, and connecting their families with the resources needed to successfully enroll.  Proposed Intervention: The goal of our project, The Eastern North Carolina Access to Better Life through Education for Kids Project (ENABLE Kids Project) is to improve access and enrollment in Early Childhood Education (ECE) programs for eligible children in Eastern NC. We will attain this goal by forming partnerships between ECE programs and Pediatric Primary Care Medical Homes (PCMH) throughout the region. This work will build on the project leader’s experience leading prevention-focused intervention development (funded by the Maternal and Child Health Bureau), implementing clinical trial operations within a primary care clinic, and conducting research on SDoH and equity in preventive care use during the COVID-19 pandemic.13  Over the next year, we will complete the planning phase for this project, with specific aims to 1) identify existing ECE programs and familiarize PCMH team members with their eligibility requirements, 2) identify both person-level and systemic barriers to accessing ECE programs, 3) assess the feasibility of developing a referral process to ECE programs for eligible children within their PCMH.  

Project Goal

Improve access to ECE programs for eligible children in Eastern NC      

Project Objective 1

Identify barriers to enrollment in ECE programs for children in Eastern NC

Project Objective 2

Build partnerships between local ECE leaders in key organizations in Eastern NC and Pediatric Medical Homes    

Project Objective 3

Analyze the feasibility of building a referral network for ECE programs housed within Pediatric Medical Homes, in preparation for application for implementation grant

AAP District

District IV

Institutional Name

N/A

Contact 1

Shaundreal Jamison, MD, MPH