DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES

Mary Allison Barlow, Judy A. McDaniel, Farha Marfani, Anne Lowe, Cassie Keplinger, Moushumi Beltangady, Novalene Goklish

Research output: Contribution to journalArticle

Abstract

Early childhood home-visiting has been shown to yield the greatest impact for the lowest income, highest disparity families. Yet, poor communities generally experience fractured systems of care, a paucity of providers, and limited resources to deliver intensive home-visiting models to families who stand to benefit most. This article explores lessons emerging from the recent Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation supporting delivery of home-visiting interventions in low-income, hard-to-reach American Indian and Alaska Native communities. We draw experience from four diverse tribal communities that participated in the Tribal MIECHV Program and overcame socioeconomic, geographic, and structural challenges that called for both early childhood home-visiting services and increased the difficulty of delivery. Key innovations are described, including unique community engagement, recruitment and retention strategies, expanded case management roles of home visitors to overcome fragmented care systems, contextual demands for employing paraprofessional home visitors, and practical advances toward streamlined evaluation approaches. We draw on the concept of “frugal innovation” to explain how the experience of Tribal MIECHV participation has led to more efficient, effective, and culturally informed early childhood home-visiting service delivery, with lessons for future dissemination to underserved communities in the United States and abroad.

Original languageEnglish (US)
Pages (from-to)276-286
Number of pages11
JournalInfant Mental Health Journal
Volume39
Issue number3
DOIs
StatePublished - May 1 2018

Fingerprint

Mothers
North American Indians
Case Management
Legislation
Alaska Natives

Keywords

  • bajos recursos económicos
  • disparidades de salud
  • disparités en matière de santé
  • early childhood
  • frühe Kindheit
  • gesundheitliche Disparitäten
  • Hausbesuchs-Implementation
  • health disparities
  • home-visiting implementation
  • implementación de visitas a casa
  • innovaciones tribales
  • innovations tribales
  • low income
  • milieux défavorisés
  • Mise en œuvre de visite à domicile
  • niedriges Einkommen
  • petite enfance
  • Stammesinnovationen
  • temprana niñez
  • tribal innovations

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES. / Barlow, Mary Allison; McDaniel, Judy A.; Marfani, Farha; Lowe, Anne; Keplinger, Cassie; Beltangady, Moushumi; Goklish, Novalene.

In: Infant Mental Health Journal, Vol. 39, No. 3, 01.05.2018, p. 276-286.

Research output: Contribution to journalArticle

Barlow, Mary Allison ; McDaniel, Judy A. ; Marfani, Farha ; Lowe, Anne ; Keplinger, Cassie ; Beltangady, Moushumi ; Goklish, Novalene. / DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES. In: Infant Mental Health Journal. 2018 ; Vol. 39, No. 3. pp. 276-286.
@article{6cf11e13fe86411eaaa7ac67e97f1fbb,
title = "DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES",
abstract = "Early childhood home-visiting has been shown to yield the greatest impact for the lowest income, highest disparity families. Yet, poor communities generally experience fractured systems of care, a paucity of providers, and limited resources to deliver intensive home-visiting models to families who stand to benefit most. This article explores lessons emerging from the recent Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation supporting delivery of home-visiting interventions in low-income, hard-to-reach American Indian and Alaska Native communities. We draw experience from four diverse tribal communities that participated in the Tribal MIECHV Program and overcame socioeconomic, geographic, and structural challenges that called for both early childhood home-visiting services and increased the difficulty of delivery. Key innovations are described, including unique community engagement, recruitment and retention strategies, expanded case management roles of home visitors to overcome fragmented care systems, contextual demands for employing paraprofessional home visitors, and practical advances toward streamlined evaluation approaches. We draw on the concept of “frugal innovation” to explain how the experience of Tribal MIECHV participation has led to more efficient, effective, and culturally informed early childhood home-visiting service delivery, with lessons for future dissemination to underserved communities in the United States and abroad.",
keywords = "bajos recursos econ{\'o}micos, disparidades de salud, disparit{\'e}s en mati{\`e}re de sant{\'e}, early childhood, fr{\"u}he Kindheit, gesundheitliche Disparit{\"a}ten, Hausbesuchs-Implementation, health disparities, home-visiting implementation, implementaci{\'o}n de visitas a casa, innovaciones tribales, innovations tribales, low income, milieux d{\'e}favoris{\'e}s, Mise en œuvre de visite {\`a} domicile, niedriges Einkommen, petite enfance, Stammesinnovationen, temprana ni{\~n}ez, tribal innovations",
author = "Barlow, {Mary Allison} and McDaniel, {Judy A.} and Farha Marfani and Anne Lowe and Cassie Keplinger and Moushumi Beltangady and Novalene Goklish",
year = "2018",
month = "5",
day = "1",
doi = "10.1002/imhj.21711",
language = "English (US)",
volume = "39",
pages = "276--286",
journal = "Infant Mental Health Journal",
issn = "0163-9641",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES

AU - Barlow, Mary Allison

AU - McDaniel, Judy A.

AU - Marfani, Farha

AU - Lowe, Anne

AU - Keplinger, Cassie

AU - Beltangady, Moushumi

AU - Goklish, Novalene

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Early childhood home-visiting has been shown to yield the greatest impact for the lowest income, highest disparity families. Yet, poor communities generally experience fractured systems of care, a paucity of providers, and limited resources to deliver intensive home-visiting models to families who stand to benefit most. This article explores lessons emerging from the recent Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation supporting delivery of home-visiting interventions in low-income, hard-to-reach American Indian and Alaska Native communities. We draw experience from four diverse tribal communities that participated in the Tribal MIECHV Program and overcame socioeconomic, geographic, and structural challenges that called for both early childhood home-visiting services and increased the difficulty of delivery. Key innovations are described, including unique community engagement, recruitment and retention strategies, expanded case management roles of home visitors to overcome fragmented care systems, contextual demands for employing paraprofessional home visitors, and practical advances toward streamlined evaluation approaches. We draw on the concept of “frugal innovation” to explain how the experience of Tribal MIECHV participation has led to more efficient, effective, and culturally informed early childhood home-visiting service delivery, with lessons for future dissemination to underserved communities in the United States and abroad.

AB - Early childhood home-visiting has been shown to yield the greatest impact for the lowest income, highest disparity families. Yet, poor communities generally experience fractured systems of care, a paucity of providers, and limited resources to deliver intensive home-visiting models to families who stand to benefit most. This article explores lessons emerging from the recent Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation supporting delivery of home-visiting interventions in low-income, hard-to-reach American Indian and Alaska Native communities. We draw experience from four diverse tribal communities that participated in the Tribal MIECHV Program and overcame socioeconomic, geographic, and structural challenges that called for both early childhood home-visiting services and increased the difficulty of delivery. Key innovations are described, including unique community engagement, recruitment and retention strategies, expanded case management roles of home visitors to overcome fragmented care systems, contextual demands for employing paraprofessional home visitors, and practical advances toward streamlined evaluation approaches. We draw on the concept of “frugal innovation” to explain how the experience of Tribal MIECHV participation has led to more efficient, effective, and culturally informed early childhood home-visiting service delivery, with lessons for future dissemination to underserved communities in the United States and abroad.

KW - bajos recursos económicos

KW - disparidades de salud

KW - disparités en matière de santé

KW - early childhood

KW - frühe Kindheit

KW - gesundheitliche Disparitäten

KW - Hausbesuchs-Implementation

KW - health disparities

KW - home-visiting implementation

KW - implementación de visitas a casa

KW - innovaciones tribales

KW - innovations tribales

KW - low income

KW - milieux défavorisés

KW - Mise en œuvre de visite à domicile

KW - niedriges Einkommen

KW - petite enfance

KW - Stammesinnovationen

KW - temprana niñez

KW - tribal innovations

UR - http://www.scopus.com/inward/record.url?scp=85047624920&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047624920&partnerID=8YFLogxK

U2 - 10.1002/imhj.21711

DO - 10.1002/imhj.21711

M3 - Article

C2 - 29800487

AN - SCOPUS:85047624920

VL - 39

SP - 276

EP - 286

JO - Infant Mental Health Journal

JF - Infant Mental Health Journal

SN - 0163-9641

IS - 3

ER -