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CSSP is a national nonprofit policy organization with a mission to achieve a racially, economically and socially just society in which all children and families thrive. DULCE (the name means sweet in Spanish) is one mechanism by which these ideas are brought to action.
Project Director Patsy Hampton explained that CSSP will award four planning grants for up to $40,000 each to accelerate local planning toward implementation. “We recognize that if you want to do something different, you need the time, space and capacity to devote to that effort, and these funds are designed to help support that,” she said.
It’s expected that selected organizations be able to craft a solid action plan over a nine-month period. The DULCE team is focused on diversifying demographic reach and interested in adaptations to the program, for instance, implementing intervention during the prenatal period.
The following themes will be considered for selection:
Geography and demographics
Equity and parent voice
Understanding of community need
Financing and sustainability
Hampton welcomed guests to the webinar and introduced DULCE co-developers Dr. Robert Sege and Samantha Morton to speak on the program and its proposed expansion.
“This is an opportunity to be part of moving from theory to practice,” Morton said, “We are excited to welcome some of you to the DULCE National Network, which is in the process of transforming child health care.”
Here are our top three takeaways from the conversation.
1. DULCE optimizes routine health care visits. DULCE meets families where they are by adding legal and early childhood system support to routine infant health care visits. When describing the components of the program, Dr. Sege highlighted “the relational approach” taken when focusing on child and family development. “In order to help families with the concrete supports they need and are entitled to,” he said, “the opportunity to have a legal partner involved is important.”
Clinics are often found in low-resourced neighborhoods where everyone has access to the services they provide. “The only factor that matters is having a baby,” Dr. Sege explained.
If a family opts in and accepts DULCE services, they can participate in some or all of the intervention components, which include structured visits and need-based interventions from an interdisciplinary team over a six-month period. During these visits, caretakers screen parents for several health-related social needs, including employment, food insecurity and housing instability. Additionally, parents receive support and guidance on how to care for their child, depending on the baby’s developing temperament and personality. Almost all families accept the support DULCE provides when offered, and almost all families complete the program in its entirety.
2. DULCE positively affects families and physicians. Results from a randomized control trial showed that families that received DULCE–versus a standard, patient-centered medical home approach–used the emergency department less. Additionally, the program substantially improved the clinic’s ability to deliver on-time immunizations to patients and provided greater access to concrete supports, including nutrition support and utility services.
The trial also showed that overall access to these concrete supports was accelerated by about six months. “Families are receiving valuable information to help them make informed decisions about access to housing, access to nutritionally rich food, economic stability and resources that can promote behavioral health,” Morton explained.
This intervention improves the experience for caretakers and providers in the clinic as well. “More than three-quarters of our families receive all well-child visits on time for the first six months of life,” Dr. Sege said, “and DULCE clinics show lower no-show rates,” ensuring that a doctor, nurse practitioner or other staff members can be available to other families when needed.
Physicians also credit DULCE with improving the work environment and reducing burn-out. Overall, speakers were thrilled to share the positive impacts of DULCE for all parties and were excited to share the opportunity to expand this program.
3. DULCE is expanding. Currently 13 communities across Vermont, Florida and California are implementing DULCE, and CSSP is seeking applications until August 21 from nonprofit organizations and local government agencies interested in implementing DULCE in their communities.