Project HOPE stands for Harnessing Opportunity for Positive, Equitable Early Childhood Development. Nemours Children’s Health is part of a Robert Wood Johnson Foundation-funded consortium promoting both equity and child well-being on a national level. How? By building the capacity of local communities, state leaders, cross-sector state teams, and local coalitions to prevent social adversities in early childhood. Part of it is making sure that stakeholder voices are heard loud and clear whenever and wherever new health strategies, policies or programs are created.
Carol Vassar, producer
Georgia Thompson, Senior Program & Policy Analyst, National Office of Policy & Prevention, Nemours Children’s Health
Trevor Lee, Program & Policy Analyst, National Office of Policy & Prevention, Nemours Children’s Health
Carol Vassar, podcast host/producer (00:00):
Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week, we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar. And now that you are here let’s go.
MUSIC: Well Beyond Medicine (00:20):
Carol Vassar, podcast host/producer (00:27):
Joining me today are two Nemours advocates committed to transforming children’s health well beyond medicine through Project HOPE, senior program and policy analyst Georgia Thompson, and program and policy analyst Trevor Lee. Project HOPE stands for Harnessing Opportunity for Positive Equitable Early Childhood Development. This Robert Wood Johnson Foundation-funded project promotes both equity and child well-being on a national level. Here’s Trevor Lee to explain.
Trevor Lee, Nemours Children’s Health (01:04):
Project HOPE was originally awarded to Nemours in October 2017. The grant came from the Robert Wood Johnson Foundation. So Nemours applied for the funding and was granted along with two other organizations, the BUILD Initiative, and Boston Medical Center Vital Village. And Project HOPE stands for Harnessing Opportunity for Positive Equitable Early Childhood Development, and it aims to ensure equitable access to health services and healthy development opportunities for young children and their families, but with the main goal to implement systems change by partnering with states and local organizations on policies and programs.
Carol Vassar, podcast host/producer (01:44):
Well, let me ask about that consortium. Talk about the critical role it plays in Project HOPE.
Georgia Thompson, Nemours Children’s Health (01:50):
So when we embarked on this work, we applied to the call for proposals from the Robert Wood Johnson Foundation individually, but there were two other qualified national organizations, the BUILD Initiative as well as the Vital Village Network at Boston Medical Center that also applied. And so we were all funded to do this work, and we all each partnered with states and communities to implement Project HOPE. And so we actually came together to form this consortium where we were able to serve as thought partners to one another on how we would implement this initiative. So we shared strategies, and with each of us having expertise in different areas and some areas that overlap, but we shared strategies. We even share a geography. We all worked in New Jersey even though we each had our individual cadre of state and community partners that we worked with together.
Carol Vassar, podcast host/producer (02:41):
How many partners would you say are part of this in total?
Georgia Thompson, Nemours Children’s Health (02:45):
In terms of the national partners that were funded by the Robert Wood Johnson Foundation, there are three of us.
Carol Vassar, podcast host/producer (02:49):
There are three? And then you have the state partners, who are numerous.
Georgia Thompson, Nemours Children’s Health (02:53):
Yes. So I would say maybe about 20 because Nemours has four state partners, BUILD had about six state partners, and Vital Village Network had about ten communities that they were working with. So I would say around 20 or so.
Carol Vassar, podcast host/producer (03:07):
And what’s the role Nemours plays in the consortium?
Georgia Thompson, Nemours Children’s Health (03:13):
Nemours is one of two partners in the consortiums that’s doing state-level systems change work. So both Nemours and the BUILD Initiative are supporting state partners to implement systems change, changes to policy, changes to practices that can help remove barriers that are impacting families’ access to critical services.
Carol Vassar, podcast host/producer (03:37):
What form does this take? If I were to walk into one of your consortium meetings, or if I were a client in one of these areas, residing in New Jersey or wherever, how would Project HOPE be impacting me?
Georgia Thompson, Nemours Children’s Health (03:52):
Project HOPE would impact a family or a community member by helping them to get the services that they need when they need them, ensuring that there are no barriers to access that service, no barriers such as transportation, there not being a location in your neighborhood, or you having to fill out an application that asks you questions that you filled out for a different service and some of the questions are the same. So removing some of those challenging barriers that really impact your day-to-day opportunities to access the services that you, your child, or your family needs. Workforce development, health services, a variety of different services that impact child wellbeing and their families.
Carol Vassar, podcast host/producer (04:33):
So talk about some of the state-based projects. How did you even know where to begin?
Trevor Lee, Nemours Children’s Health (04:40):
So each of the states that Nemours works with has a different area of focus. And to begin the project, each state team formed a cross-sector state stakeholder group, and they worked together to gather data to determine some of the areas where the main target populations would benefit most from advancements in policy. And then, the state teams develop the pilots to begin influencing those policies that would impact these priority areas.
For instance, in Florida, they are mainly focused on social-emotional development and increasing child developmental screening. New Jersey’s main focus is health and childcare strategies that intersect with labor and workforce. Oklahoma’s focus is building a stronger feedback loop through story gathering, which is a bit of a shift from their original focus, which was actually infant mortality. And then Washington’s main focus is the expansion of the Help Me Grow model in the state of Washington.
Carol Vassar, podcast host/producer (05:44):
How did you determine where to do these projects?
Georgia Thompson, Nemours Children’s Health (05:48):
Nemours did look at a number of different qualifications, if you will, for our state partners. We wanted to ensure that they had these existing groups that Trevor mentioned, the cross-sector state stakeholder groups. We wanted them to have a group in place that could almost serve as maybe an advisory group to the work that their Project HOPE completed. We want to ensure that they had other statewide initiatives that were focused on child health and wellbeing. Each of our state partners, they have other state grants, such as Early Childhood Comprehensive Services, focused on aligning services for children and families. They have the preschool development birth-to-five grants. They may have a Pritzker Early Learning Childhood Initiative grant. So we wanted to also make sure they had some other statewide initiatives that they could integrate or align with their efforts for Project HOPE that could also sustain this work as well.
Carol Vassar, podcast host/producer (06:40):
What did you learn? You’re in four different areas. You must have learned a ton.
Georgia Thompson, Nemours Children’s Health (06:45):
We did. We learned quite a bit from Project HOPE. As a matter of fact, we started to track lessons learned. Our evaluation partner, Altarum, helped us to do this, and then eventually, we started working with an independent consultant for our evaluation for Project HOPE. And we tracked quite a few. I’ll share just a few of them. One of the major things that we learned is that the work looks very different in the individual states based on geography, demographics, state capacity to do this work, the policy landscape in each of the different states. It looked very different. And so we were glad that we allowed our states to determine what their state focus would be in terms of addressing issues of equity. We wanted them to look at the state and community data. We wanted them to be informed by their own data in terms of determining what they would focus on for Project HOPE.
We also learned that there needs to be increased and flexible funding for states to do this type of exploratory work to identify our solutions that are going to advance equity. I mean, we learned that equity should drive this work. These strategies that we utilize throughout Project HOPE, centering equity and supporting states with training and technical assistance to support that, really help to accelerate states’ progress. And so we definitely learned that equity needs to be at the focus. We need to work on systems change in terms of policy and practices that are going to ensure that all of our children and families that we’re working with have equitable access to high-quality services.
I mentioned that we learned that the states need that training and technical assistance. They have great state capacity in different areas, a lot of our states. They have strengths, existing strengths, and they were further strengthened by the training and technical assistance that they received through Project HOPE to do this work.
And then finally, another lesson learned was our states were employing a variety of different strategies to engage communities so that the communities could inform the strategies for systems change. We want to ensure that community voice is lifted up throughout this process, and even after Project HOPE, we want to ensure that. And so our states were already employing a variety of strategies to do so. In Florida, they were working on developing a parent leadership model. They were training parents in advocacy strategies so that they could collaborate on these processes and inform the strategies that states would implement in order to strengthen families’ access to services. In Oklahoma, they utilize a story-gathering framework to ask community members questions about their experiences with the services that they were utilizing, and so that was their way of engaging communities. And then they would take the data, they would synthesize it, and then go back into the communities and say, “This is what we heard from you based on that. These are some of the strategies that we would like to explore going forward.” And so that helped to integrate the voice of the community and get their feedback. Other states use focus groups or what we called Community Action Labs that brought community leaders and parents together to brainstorm strategies. So our states really use a number of different strategies to ensure that we engaged community members in informing the very services that would impact them as beneficiaries.
So lots learned here, and we captured a lot of that throughout the process, fortunately, and we will be sharing that. We have shared some early lessons learned, and we’ll continue to share them from the project.
Carol Vassar, podcast host/producer (10:06):
Three words that I hear both of you, again and again, saying are equity, integration or some form thereof, and community involvement. Talk about each of these, the importance of each of these. It sounds like these are real keys to the success of Project HOPE.
Georgia Thompson, Nemours Children’s Health (10:27):
In terms of equity, as I mentioned, we try to ensure that it’s at the center. The goal here is really to ensure that barriers that sometimes are created by systems, that these barriers are removed so that families can access the services that they need. If their child needs an evaluation for an early child intervention, want to ensure that they receive access to that, that there are no barriers, like I mentioned earlier, such as transportation. There isn’t one in my neighborhood. It’s been open during these hours, and I work during those hours, or I don’t have childcare so that I can get an employment opportunity. We want to ensure that families have access to the services that they need, equitable access to high-quality services. So that’s really the focus here.
As I mentioned earlier, states were able to choose their focus issue, but we wanted equity be to be the center. We provided training. We partner with an organization called the Institute for Public Health Innovation to provide this curated training to each of our states so that we could speak a common language when we talk about equity and the strategies that are employed here. IPHI, as we call the Institute for Public Health Innovation, also introduced our states to a tool called the Equity Impact Review tool. This tool helps state leaders to really dig deeply and see how the proposed solutions or proposed policy changes would impact individuals, impact communities, impact families before they actually put them into action. And so that helps us to rethink, revise as necessary, and pivot as needed in order to make sure that there are no unintended consequences of new programs or new policies that we want to implement to help serve families.
Carol Vassar, podcast host/producer (12:10):
How do communities benefit when population health networks become strategic and deliberate in using and applying integrative activities and services?
Georgia Thompson, Nemours Children’s Health (12:22):
We’ve learned that the alignment of systems at the state level could yield better outcomes for families. When state systems talk to one another, we can reduce those barriers I mentioned. We can reduce redundant enrollment processes for services. We can increase access and enrollment by screening for other services during intake. We can also integrate our data systems so that they talk to one another across the state, and then that can help us to facilitate better service delivery models. And so it’s really about simplifying this process and where possible, allowing the state systems to talk to one another. A lot of the systems are serving some of the same families, so why are we completing 10 different applications that are 10 pages? Or why aren’t we asking parents, “Do you need childcare?”, if we’re providing them with employment opportunity support services? So we really want to be able to truly meet the needs of families and communities, and we want to meet them where they are. And so we can do that and we can remove these barriers that impact their ability to take advantage of these really important family support services.
Carol Vassar, podcast host/producer (13:29):
And I’m hearing all of this, and as we start the new year, I’m hearing very much in alignment with the strategic plan put forth by Nemours last year. Project HOPE fits nicely into that. Talk about that a little bit.
Georgia Thompson, Nemours Children’s Health (13:45):
It really does. It really does. And Project HOPE is aligned with the strategic pillars, specifically the health equity, and value. We’ve talked a lot about equity here and we’re looking to improve health outcomes for young children. And so, Project HOPE really aligns very nicely with the health equity and value strategic pillar by intentionally looking at different ways to better serve children and families. And then Project HOPE also really aligns with Nemours’ strategic pillar of building our national reputation. We’re doing that because we’ve formed so many important partnerships through this work. We’ve really relied on the expertise of national experts, national partners to provide technical assistance training for our states.
We’ve also shared our learnings nationwide. The national office has our movinghealthcareupstream.org website. It has a Project HOPE webpage, and we’ve shared lots about Project HOPE, our states, what they’re working on, what they’re accomplishing. And we’ve offered webinars. We’ve hosted national convenings for our states. We want to share and celebrate the work of our state and community partners. And we’ve also developed a series of tools and resources to support other organizations that are doing similar systems change work, and all of this information is publicly available on movinghealthcareupstream.org. And we’re actually right now in the process of developing a compendium, compiling all of these resources, action plan templates, presentations, a guide for selecting data indicators, a number of different things that can be really helpful to state and community leaders across the country that are working on initiatives that are very similar to Project HOPE.
I would like for Trevor to talk about that community angle and the importance of some of the things that we’re doing and learning there.
Trevor Lee, Nemours Children’s Health (15:28):
Yeah, so on top of everything that Georgia shared, some other impacts of Project HOPE in terms of where communities benefit are the better establishment of feedback loops between the community voice being shared directly, sharing their priorities, and the different areas of focus. With the feedback loops being established, we get a better sense of what they actually need versus the state dictating what they want to provide. We also thought that was a huge benefit of Project HOPE.
Carol Vassar, podcast host/producer (16:03):
It sounds like collaboration is another keyword in Project HOPE.
Trevor Lee, Nemours Children’s Health (16:08):
Carol Vassar, podcast host/producer (16:10):
So I have a question. You started in 2017. We had a pandemic that started in 2020, seemingly endless even though we’re into 2022. How did that impact the work that was being done for Project HOPE?
Trevor Lee, Nemours Children’s Health (16:24):
The pandemic did have a big impact on Project HOPE, but Robert Wood Johnson Foundation has been very flexible and understanding in terms of the effects of the pandemic. So a lot of on-the-ground activities within the communities were affected. This caused a big shift from actual in-person activities to a more virtual format in several areas. And then a lot of priorities were shifted to meet immediate needs. We were able to work with our different state teams to identify community organizations that could assist with distributing resources to address food insecurity. Those issues were presented by the pandemic, and RWJF allowed us to reallocate funds and provide stipends for them to purchase these resources and to distribute them within the community and across the states.
Georgia Thompson, Nemours Children’s Health (17:22):
Absolutely. Trevor mentioned the feedback loops, and so we had states and communities. They had a direct line to one another. And so for example, in New Jersey, we were able to shift from our Project HOPE meetings to a meeting where we were discussing needs on a weekly basis and hearing directly from the community service providers. This is what’s needed in this neighborhood, this is what’s needed in this community and hear directly from them. And then, with the flexibility of our funding, we were able to quickly turn around and put resources in those communities, such as food and supplies.
Carol Vassar, podcast host/producer (17:51):
So where do you go from here? Where is Project HOPE going in 2022 and moving forward?
Georgia Thompson, Nemours Children’s Health (17:57):
Project HOPE states have learned a lot throughout this process. They have been working on developing a three-to-five-year action plan for systems change, and they have then taken those action plans and they piloted them at the community level before going to full scale to learn how this would impact the community, what this would look like in action. And so from those community pilots, they have revised their action plans, and we hope that their course of action is strengthened by the training, technical assistance, and support that they receive from Nemours and its partners for Project HOPE.
And so they could very well be ready to scale. They may be looking at moving forward and collecting additional data, looking at evaluation. But these action plans have really given them the opportunity to think intentionally about how do we do this. How do we take what we’ve learned and put into action? How do we change this particular policy or change this program to make things more accessible to our children and families? And so they’ve thought about the evaluation of it. They’ve thought about what partners and what resources are needed, what strategies they will use to engage the community so the community can inform the strategies. So there’s been a real comprehensive look at these potential solutions that our states will implement with the three-to-five-year action plans.
We’re in the process of compiling all of our resources to share our learnings with everyone, anyone that’s working on systems change work, work to improve the quality, or to improve the access to services and resources that impact children and families. We have lots of knowledge and learnings to share from Project HOPE. And so you can visit our website, movinghealthcareupstream.org/projecthope, or you can contact us at firstname.lastname@example.org to receive access to this. And often, we share some of our updates on the Nemours Twitter page, and so you can see lots of our learnings there posted there as well, such as our Project HOPE state profiles. And so we are ready and willing to share all that we’ve learned, and it’s been a tremendous experience working with our states. Learning from them as well has been awesome, and just connecting with great partners across the country. It’s four or so years, and it’s flown by. With what we’ve learned, we really hope to impact outcomes for child health and wellbeing.
Carol Vassar, podcast host/producer (20:19):
Thanks for listening to our episode on Project HOPE with me, Carol Vassar, and our guests, Georgia Thompson, and Trevor Lee. What are your thoughts? Where do you see opportunity within Project HOPE and beyond? Visit nemourswellbeyond.org to submit a comment or leave us a voicemail. While you’re there, check out our other episodes and be sure to subscribe to the podcast.
Thanks to Peter Adebi, Allison Craft, and Deborah Griffin for this week’s production assistance. Join us next week as we discuss genetic medicine and genetic counseling for kids. Until then, remember, together, we can change children’s health for good, well beyond medicine.
MUSIC: Well Beyond Medicine!