Accomplishing Great Things Together: a Cross-State Synthesis of Essentials for Childhood Grantees’ Efforts to Prevent Child Maltreatment

Abstract

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.

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