The purpose of CDC’s Essentials for Childhood (EfC) initiative was to assure safe, stable, nurturing relationships and environments and prevent child maltreatment. SciMetrika supported the evaluation of this initiative by collecting, tracking, analyzing, and reporting data on Essentials for Childhood grantees’ efforts to implement the four primary goals of CDC’s Essentials for Childhood Framework using a collective impact approach. In this article, we report quantitative and qualitative findings from our analysis of data sources collected from funded states over the five-year period. Further, we describe key successes and barriers to implementing the EfC framework at the state level using the collective impact model. These lessons learned can be applied to other state-level initiatives looking to implement a public health framework to address a complex social issue.
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This work has been funded by the Centers for Disease Control and Prevention (Contract No. 200-2014-F-60746). The authors have no relevant financial relationships interest or conflicts of interest to disclose.
Appendix: Collective Impact Assessment Tool
Appendix: Collective Impact Assessment Tool
Progress in the collective impact process to assure safe, stable, nurturing relationships and environments for ALL children (Essentials for Childhood) Date:
Please rate on a scale of 0–10; if the process in your state hasn’t reached that step, please report “NA”.
|Indicator||Non-existent or very weak = 0||Strong = 10||Score||Main reasons for this score|
|Backbone capacity||Staff, knowledge, skills, or resources are insufficient to facilitate the process||Staff, knowledge, skills, and resources, are sufficient to facilitate the process|
|Ineffective at engaging the steering committee, managing relationships, and is not respected by partners||Effectively engages the steering committee, manages relationships, and is well-respected by partners|
|Common understanding||Confusion or tension within steering committee on scope or causes of the problem||Partners show shared understanding of the problem and its causes (all can articulate the problem & its causes)|
|Partners afraid to share their views, setbacks, challenges, and failures with one another||
Backbone has established|
a culture of trust, respect, and
learning among partners
|Common agenda||No shared goals||Steering committee reaches consensus on shared goals, population group, and geographic boundaries|
|Steering committee does not use data to select strategies||Steering committee used data to inform selection of strategies|
|Partners communicate goals in inconsistent ways||Partners accurately communicate (in meetings, to the public, etc.) goals|
|Partners not advocating for initiative’s goals||Partners advocate (in meetings, to the public, etc.) for initiative’s goals|
|Engagement||Relevant partners/stakeholders missing||Relevant partners (including community voices) fully engaged|
|Communication structures and processes insufficient to keep partners engaged and informed||Regular meetings & communications keep partners engaged and informed|
|Zero buy-in||Buy-in very high|
|No sense of urgency||High sense of urgency|
|Partners don’t know what their role might be||Partners articulate their role in effort|
|Mutually reinforcing and aligned activities||No collaborative work||Partners identify collaboration opportunities|
|No action plan||Action plan clearly specifies the activities that each partners has committed to implementing|
|Activities duplicated or counter- productive with gaps remaining||Partners coordinate activities, duplicate efforts eliminated, gaps filled|
|Funding not aligned||Partners align or redirect available funding towards initiative’s goals|
|Professional training, standards and practices no aligned||Professional training, standards and practices aligned to support EfC goals|
|Shared measures||No agreement on shared metrics||Partners agree on shared metrics|
|No review of progress; decisions based on personal opinions, experiences, or anecdotes||Steering Committee regularly reviews progress and makes decisions based on data|
|Mobilize funding||No new funds||New funding contributed towards goals|
|Context||Cultural, political, or socioeconomic factors get in the way of progress||Cultural, political, socioeconomic factors contribute to progress|
|Build public will (Awareness & Commitment)||No influential champion||Several well-respected champions passionate about the problem|
|Public unaware of ACEs, their social determinants, or how to prevent them from occurring||Public highly aware of the impact of ACEs, their social determinants, and how to prevent them from occurring|
|Norms ignore ACEs and toxic environments or consider them an issue of “those people”||Norms change to support safe, stable, and nurturing relationships and environments for ALL children|
|Dominant narrative/framing gets in the way of policy changes that would be supportive of children and families||Effective framing and messaging is widely used & is changing the public narrative in ways that support policy change|
|No public expression of support for preventive action||Public expresses support for preventive action|
|No public action towards preventive solutions||Public takes action towards preventive solutions|
|Policy change||No policy agenda or relationships with policy-makers or policy-movers||Initiative has a policy agenda and relationships with policy-makers and policy-movers|
|Partners don’t know how to talk about what policies or why||Partners have talking points and provide consistent messages|
|Policy-makers unaware of the impact of ACEs and their social determinants||Policy-makers highly aware of the impact of ACEs and their social determinants|
|Policy-makers unaware of policies that can prevent ACEs from occurring||Policy-makers highly aware of policies that can prevent ACEs from occurring|
|No expressed support from policy-makers for preventive action||Policy-makers express support for preventive action|
|No new policies proposed that align with goals||Policy-makers propose policy changes aligned with goals|
|Policies contribute to increased ACEs||Policies increasingly aligned with goals|
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Wasilewski, Y., Shaw, D. & Hawley, L. Accomplishing Great Things Together: a Cross-State Synthesis of Essentials for Childhood Grantees’ Efforts to Prevent Child Maltreatment. Int. Journal on Child Malt. 1, 205–222 (2019). https://doi.org/10.1007/s42448-018-0011-1
- Child abuse
- Child neglect
- Child maltreatment
- Collective impact