What questions has PHP been grappling with over the past year in your parent-centered work?

One critical question we have been addressing is, “How to support efforts that build on family strengths and assets while identifying and addressing systemic barriers that are at the root of inequities?”

As a funder focused on advancing equity in health, we strive to promote people’s physical, mental, and social well-being across the lifespan and to eliminate health disparities. Over the years, many of our direct service and advocacy strategies have been informed by our assessment of unmet needs and desire to mobilize action in response to injustice. While our commitment to shining a light on inequities has not wavered, we are challenging ourselves to pursue and support affirmative approaches focused on what families prioritize and seek rather than only focusing on what they lack or need. We partner with grantees who are committed to engaging family voice and leadership in the design, implementation, and evaluation of their programs and services, informing changes in practice over time.

For example, for more than a decade, we have supported medical-legal partnerships (MLP) that integrate public interest law services in medical settings to address social and economic drivers of health (e.g., housing/habitability, public benefits and health insurance access, family law, employment conditions, etc.). In response to feedback from families including patient advisory council members, our grantee Legal Clinic for the Disabled (LCD) transformed their legal needs screening tool into an assets-based Family Resource Guide. Parents and caregivers at the St. Christopher’s Hospital for Children MLP site are now asked if they “would like help with” rather than whether they “have a problem with ….” – followed by prevalent legal and social services categories. While this shift in the framing of the question may seem subtle, the goal is to respect and reinforce families’ agency and self-determination while avoiding stigmatizing language. LCD has translated the new guide into Spanish and Arabic – the two most common languages spoken by St. Christopher’s patient families after English—and included illustrations to promote understanding. LCD will continue to evolve and update the resource guide informed by ongoing engagement with parents and caregivers and assessment of whether this approach increases families’ connection with services.

Another question we have been tackling this past year is, “How to broaden our knowledge of and support for parent and caregiver organizing and community action in Philadelphia?”

At PHP, we have established relationships with advocacy organizations doing critical work to drive early childhood policy and systems change at the state and local levels. Our advocacy grantees are informed by family voice and work to engage parents and caregivers as leaders in defining and implementing their agendas. We support these efforts through our financial and human capital, both making grants and engaging with cross-sector stakeholders and public sector officials in support of policy and systems changes pursued by our grantees. At the same time, we are committed to increasing support for parent and caregiver-led organizing in Philadelphia neighborhoods and communities. We are eager to determine whether there are pre-existing groups of parents and caregivers active on early childhood issues that have been under-resourced and/or overlooked. We also want to learn from parents and caregivers themselves about what platforms would best support their leadership in shaping improvements to early childhood services, policies, and systems. Our first significant step in that direction is the launch of the Early Childhood Parent and Caregiver Organizing Fund as described below.

What have you been testing and learning around parent-leadership and partnership work?

In 2022, we partnered with Bread & Roses Community Fund (Bread & Roses) to develop an Early Childhood Parent and Caregiver Organizing Fund. Using a participatory grantmaking approach, the new Fund will engage parents and caregivers to allocate resources in support of early childhood organizing and community action focused on issues that parents and caregivers themselves identify and prioritize. Vanguard Strong Start for Kids – a co-champion of family voice and leadership – is supporting this Early Childhood Parent and Caregiver Organizing Fund through their collaboration with Start Early on family-centered design.

For more than four decades, Bread & Roses has used community-led grantmaking to build collective action across differences of race, class, and identity and to foster power, leadership, and agency among community members organizing for racial, social, and economic justice. To support an equitable decision-making process, Bread & Roses facilitators cultivate and nurture relationships to ensure each participant in the grantmaking process feels safe and heard. Bread & Roses also invests time and resources in creating the conditions for each person to be able to participate fully: i.e., making sure the physical (or virtual) gathering space is accessible, serving nourishing food, offering childcare and transit reimbursement, and providing simultaneous interpretation when needed.

Following the first year of the Early Childhood Parent and Caregiver Organizing Fund, Bread & Roses will convene a community of practice among grant recipients. Groups that receive funding will have an opportunity to connect with each other for mutual support and learning, to identify common barriers and challenges, and to make recommendations to funders and policymakers about how to continue, adapt, and/or expand our support for family voice and leadership. We are committed to communicating with participants about how we will apply the knowledge and experience shared to inform and evolve our own practices.

This year, we also supported Children’s Hospital of Philadelphia (CHOP) to begin implementation and evaluation of a three-year pilot of HealthySteps, a program of ZERO TO THREE, at the CHOP Primary Care location in the Cobbs Creek neighborhood of Philadelphia. The pilot site will join a national network of HealthySteps programs working to transform pediatric care by promoting nurturing parenting and healthy development for babies and toddlers. The HealthySteps model adds a child and family development professional, known as a HealthySteps specialist, to the pediatric primary care team for patients ages 0 to 3. The HealthySteps specialist offers screening and support for common and complex parenting challenges (e.g., feeding, attachment, behavior, sleep, maternal depression, and adapting to life with a baby or young child). Trained specialists also provide guidance, referrals, and care coordination for families who need them.

The HealthySteps pilot aims to improve child and family outcomes through early identification of needs, improved service accessibility, and enhanced family engagement and support. Central to CHOP’s approach will be the formation and engagement of a Family Advisory Committee (FAC) to provide feedback to the HealthySteps team and Cobbs Creek clinical/medical practice leadership on implementation and evaluation goals, design, and findings. The FAC will consist of four to six parents and caregivers who have children aged 0-3 and receive care at the clinic. The FAC will meet on a bimonthly basis, and members will receive a $35 gift card and transportation assistance for each meeting attended. FAC members will be recruited by practice providers and staff with the goal of engaging a diverse group that is representative of the Cobbs Creek community.

Related to the three-year HealthySteps pilot, we are eager to learn from the experiences of the Family Advisory Committee and to understand members’ perspectives regarding their participation in the HealthySteps program as a parent or caregiver and their leadership on the FAC. We recognize the difference between soliciting parent input and engaging parents as part of a co-design and decision-making process and are eager to learn from both CHOP and Bread & Roses parent and caregiver participants about the conditions that support their full inclusion and engagement as desired by each member.

What does the future look like for PHP’s parent partnership work?

At PHP, we are committed to partnering with parents and families across all aspects of our work and strategic initiatives. As we continue to build the foundation’s capacity for parent and caregiver leadership and partnership, we strive to recognize and engage the diversity inherent in the identity of “parent” or “caregiver.” We do not expect all families with young children to share the same vision or priorities, and we acknowledge that parents and caregivers may have very different preferences (and availability!) in terms of their engagement. We believe it is important to offer different types and opportunities for parent leadership and partnership and to avoid ignoring or minimizing different experiences or perspectives. Through our expanded focus on perinatal health and well-being, we plan to enlarge our frame of reference for parent and caregiver voice and leadership to focus on domains of health and well-being that may be independent of child outcomes. For instance, we know that the mental health of parents and caregivers is integrally connected with family well-being, but we don’t want to assume that the priorities of adults are always synonymous with the interests of their children. We have more to learn about how to support families as units while engaging respectfully with differences across generations and developing spaces and opportunities where parents and caregivers can be honest about the multiple roles they play, the trade-offs they face, and the conditions that support their ability to thrive. We endeavor to move forward above all with humility and respect.

In addition to the examples provided above, here are two other parent-centered grantees doing great work.

ParentChild+: We support the ParentChild+ (PC+) to provide home visiting services for Philadelphia families with children between the ages of 16 months to four years old to stimulate parent-child interaction and develop children’s language, early literacy, and social-emotional skills. PC+ Early Learning Specialists come from the communities they work in and use a strengths-based approach to identifying and developing families’ parenting knowledge and linguistic practices. PC+’s impact extends beyond families directly served to include intentional efforts to provide career pathways for neighborhood residents.

University of Delaware Attachment Biobehavioral Catch-Up: We are supporting the expansion of the evidence-based Attachment Biobehavioral Catch-Up (ABC) Program in the Philadelphia Infant Toddler Early Intervention system. ABC promotes early childhood development by supporting parents and caregivers to foster responsive and nurturing relationships with their infants and toddlers.