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November 2, 2021

Statewide ABC Project Shows Promise Across Kansas and Cultures

The 10-week early childhood home visiting program results are promising in Kansas: healthier children, more confident caregivers, and stronger families

Can a 10-week home visiting program for caregivers of infants and toddlers result in healthier Kansas children? The results from a three-year-long initiative say yes.

From May 2017 through April 2020, the Kansas ABC Early Childhood Initiative brought the evidence-based Attachment and Biobehavioral Catch-up (ABC) intervention to five sites in Kansas to evaluate the effectiveness of integrating the program into the existing array of early childhood programs across the state.

Kansas Overall Evaluation Findings

“Our evaluation team was excited to find that the Kansas ABC Early Childhood Initiative had positive outcomes in Kansas including healthier children, more confident parents and caregivers, stronger families, and more comprehensive services and systems,” said Amy Mendenhall, director of the Center for Community Engagement & Collaboration at the University of Kansas.

Over the course of three years, 536 families were screened for toxic stress across 36 counties. In that time, 402 families were enrolled in the ABC intervention, and 682 caregivers and 907 children were impacted.

After completing ABC:

  • Caregiver concerns regarding child social-emotional functioning decreased.
  • Children’s cortisol levels, an indicator of stress, became more normalized. However, the change was not statistically significant for the entire sample.
  • Parent coaches rated children’s overall wellbeing as more positive.
  • Caregivers’ knowledge, and beliefs in their caregiving abilities, increased.
  • In interactions with their children, caregiver intrusiveness went down, while sensitivity and delight went up.
  • Caregiver capabilities significantly improved.

Evaluation Findings for ABC Delivery in Spanish

The initiative included four parent coaches who delivered the program in Spanish. Approximately 41% of families served were Hispanic or Latinx, and 22% primarily spoke Spanish in the home. Overall, the findings were similar for families who received ABC in Spanish as those who received it in English.

Coaches experienced some challenges in translating the program and its core concepts. Overall, they shared positive experiences regarding the cultural relevance of the program and having a coach who spoke Spanish and was Latinx.

“It was important to have the initiative reflect the changing demographics in our state,” said David Jordan, United Methodist Health Ministry Fund president and CEO. “We were excited to see positive results for our Spanish-speaking families. We shared those findings—and the challenges in translating materials and some concepts—with the program developers at the University of Delaware.”

Lessons Learned for Policymakers and Funders

As policymakers explore evidence-based strategies to
– prevent utilization of the child welfare system,
– keep children with their parents in their homes,
– improve health,
– build parenting skills, and
– address equitable attainment of education,
the report detailing the Kansas experience with ABC highlights its potential as a worthy, evidence-based investment.

Kansas has already moved in this direction by providing Family First dollars to support ABC projects as part of child welfare prevention strategies deployed under Family First. Likewise, the Kansas Department of Education has recognized ABC as an approved program for equity funds at the state level, and Medicaid is reimbursing mental health providers using ABC for eligible children.

Given the success of ABC in normalizing cortisol levels and lessons learned from other states – like New York, which utilized ABC to sustainably reduce child welfare caseloads and aid reunification efforts – there is great potential for policymakers to further support evidence-based programs like ABC to advance child health and child welfare goals as well as improve educational attainment.

Continued investment from foundations and early childhood stakeholders in ABC and other evidence-based programs will offer important opportunities to test, pilot, and evaluate programs to inform and maximize the return on future investments affecting generations to come.

Kansas ABC Findings

Five philanthropic organizations brought the ABC program to Kansas: United Methodist Health Ministry Fund, Hutchinson Community Foundation, Kansas Health Foundation, REACH Healthcare Foundation and Wyandotte Health Foundation.

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© United Methodist Health Ministry Fund