2012-13 annual evaluation report - first 5...

FIRST 5 SANTA CRUZ COUNTY

July 1, 2012 - June 30, 2013

October 2013

ANNUAL EVALUATION REPORT

Acknowledgements

First 5 Santa Cruz County would like to acknowledge Applied Survey Research (ASR) for their support and assistance with the evaluation and this report. First 5 Santa Cruz County also thanks Nicole Young, of Optimal Solutions Consulting, for the close collaboration in crafting the procedures necessary to successfully evaluate the Triple P program, and also for her extraordinary help and guidance with all of our funded programs during the entire year.

First 5 Santa Cruz County would also like to thank the staff and participants of the funded partner agencies whose commitment to data collection has facilitated the gathering of the robust data included in this report.

First 5 Santa Cruz County Applied Survey Research Optimal Solutions Consulting

Susan True Stephanie Bluford Vicki Boriack Angela Cline Barbara Dana Irene Freiberg Holly Maclure Christine Sieburg Karen Sullivan Nicole M. Young Alicia Zenteno

Susan Brutschy Lisa Colvig-Amir Kim Carpenter Javier Salcedo Melanie Espino Christina Branom

Nicole M. Young

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT TABLE OF CONTENTS

FIRST 5 SANTA CRUZ COUNTY i

Table of Contents

Executive Summary ....................................................................... 1

Overall Well‐Being of Children in the County ............................................................................ 3

A Profile of First 5 Participants ................................................................................................. 5

Healthy Children ...................................................................................................................... 6

Strong Families ........................................................................................................................ 8

Children Learning and Ready for School ................................................................................. 10

Service Integration & Community Strengthening .................................................................... 13

Summary ............................................................................................................................... 14

Part 1: Strategic Framework Results ............................................ 17

First 5 Santa Cruz County’s Strategic Framework .................................................................... 19

Overall Well-Being of Children in the County .................................................................... 21

A Profile of Santa Cruz County’s Youngest Children ................................................................ 21

County‐Wide Trends in Indicators of Child and Family Well‐Being .......................................... 22

Profile of Participants ......................................................................................................... 23

Number of Children and Families Served ................................................................................ 23

Increase Services into Communities with the Highest Needs .................................................. 25

Early Childhood Educators Served by First 5 Partners ............................................................. 28

Healthy Children ................................................................................................................ 29

Increase Insurance Coverage .................................................................................................. 29

Increase Use of Medical/Dental Homes .................................................................................. 33

Increase Use of Preventive Health Services ............................................................................ 35

Increase Number of Children Reaching Developmental Milestones ........................................ 37

Strong Families .................................................................................................................. 39

Decrease Child Abuse and Neglect ......................................................................................... 39

Improve Parent and Caregiver Practices that Support Children’s Social and Emotional Development ......................................................................................................................... 41

Children Learning and Ready for School ........................................................................... 47

Increase the Quality of Early Learning Programs ..................................................................... 47

Improve Early Literacy Skills of Children ................................................................................. 51

Service Integration & Community Strengthening ................................................................ 65

First 5 Service Integration ....................................................................................................... 65

TABLE OF CONTENTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT

ii FIRST 5 SANTA CRUZ COUNTY

First 5 Fiscal Status and Sustainability .................................................................................... 66

Community Strengthening ..................................................................................................... 69

Part 2: Partner Profiles ................................................................ 71

Healthy Children ................................................................................................................. 74

Healthy Kids Initiative ............................................................................................................ 74

Neurodevelopmental Clinic ‐ Dominican Interdisciplinary Child Development Program ......... 79

Strong Families ................................................................................................................... 84

Families Together .................................................................................................................. 84

Triple P – Positive Parenting Program .................................................................................... 91

Triple P Highlights ................................................................................................................................... 93

Population Served ................................................................................................................................. 101

Details of Program Participation .......................................................................................................... 104

Building a Population‐Based System of Parent Education ................................................................... 109

La Manzana Community Resources ...................................................................................... 112

Mountain Community Resources ......................................................................................... 118

Side‐by‐Side ......................................................................................................................... 123

Children Learning and Ready for School .......................................................................... 126

Quality Early Learning Initiative ........................................................................................... 126

Race to the Top – Early Learning Challenge ......................................................................................... 126

Child Signature Program (CSP) ............................................................................................................. 127

Starlight Children’s Center ................................................................................................... 130

Early Literacy Foundations (ELF) Initiative ............................................................................ 134

SEEDS of Early Literacy ......................................................................................................................... 135

SEEDS Plus ............................................................................................................................................ 137

Santa Cruz Reading Corps..................................................................................................................... 138

Raising A Reader .................................................................................................................. 155

Summer Pre‐K Academy ...................................................................................................... 157

Transition to Kindergarten ................................................................................................... 159

Child Snapshot ...................................................................................................................................... 159

Transition to Kindergarten Workshops ................................................................................................ 165

Appendices ................................................................................ 167

Appendix A: First 5 Santa Cruz County Strategic Framework ................................................ 169

Appendix B: Race to the Top – Quality Continuum Framework: Hybrid Matrix ..................... 171

Appendix C: Measurement Tools ......................................................................................... 173

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT TABLE OF FIGURES

FIRST 5 SANTA CRUZ COUNTY iii

Table of Figures

Figure 1: Number of County Children ages 0‐5 .................................................................................................................. 21

Figure 2: Ethnicity of County Children ages 0‐5 (2013) .................................................................................................... 21

Figure 3: English Language Proficiency of County Kindergarteners (2012‐13) .................................................................. 21

Figure 4: Number of Services to Children and Parents, by Goal Area (2012‐2013) ........................................................... 23

Figure 5: Percentage of Children 0‐5 in Santa Cruz County Served by First 5 .................................................................... 24

Figure 6: Demographics of Children Participating in First 5 Programs, by Year ................................................................. 25

Figure 7: Levels of Children’s Vulnerability in Santa Cruz County, by ZIP code .................................................................. 26

Figure 8: Distribution of Children Who Received Services, by ZIP Code (2012‐2013) ........................................................ 27

Figure 9: Number of Children Who Received Services, by ZIP Code (2012‐2013) ............................................................. 27

Figure 10: Percentage of Children Ages 0‐5 Estimated to be Insured .................................................................................. 29

Figure 11: Number of Children (Ages 0‐5) Newly Enrolled by HCOC in Publicly‐Funded Health Insurance Programs ......... 30

Figure 12: Number of Children (Ages 0‐5) Re‐Enrolled by HCOC in Publicly‐Funded Health Insurance Programs .............. 31

Figure 13: Newborn Enrollment Project Statistics (2012‐2013) ........................................................................................... 32

Figure 14: Percentage of Children in the County Enrolled in Healthy Kids (Ages 2‐6) Who Had Access to a Primary Care Practitioner .................................................................................................................................... 33

Figure 15: Percentage of County Parents Reporting their Children Utilized Health Care Prior to Renewal in an Insurance Program .............................................................................................................................................. 33

Figure 16: Percentage of County Children Receiving Dental Care (Ages 0‐5) ...................................................................... 34

Figure 17: Rate of California Children Visiting the ED for Preventable Dental Conditions (per 100,000, Ages 0‐5) ............ 34

Figure 18: Percentage of Children (Ages 3‐6) in the County Enrolled in Healthy Kids Who Received a Well‐Child Visit ..... 35

Figure 19: Percentage of Children (Ages 0‐5) in the County Who Visited the Emergency Department in the Past Year .... 35

Figure 20: Number of Emergency Department Visits (Infants Less Than One Year Old) ..................................................... 36

Figure 21: Percentage of County Children in Kindergarten Enrolled in Special Education .................................................. 37

Figure 22: Demographics of the Children (Ages 0‐5) Participating in the DICDP (2011‐2013) ............................................. 37

Figure 23: Percentage of Children in DICDP (Ages 0‐5) With These Diagnoses and Services, at Intake (2011‐2013) .......... 38

Figure 24: Percentage of Children in DICDP (Ages 0‐5) Provided With These Referrals (2011‐2013) .................................. 38

Figure 25: Rate of Substantiated Allegations of Child Maltreatment in Santa Cruz County and California (per 1,000)....... 39

Figure 26: Change in Families Together Participants’ Risk Levels Over Time (2007/08 ‐ 2012/13) ..................................... 40

Figure 27: Percentage of Parents Who Demonstrated Improvement in One or More Key Parenting Domain (2010‐2013) ......................................................................................................................................................... 43

Figure 28: Parents’ Use of Positive Parenting Styles (2010‐2013) ....................................................................................... 44

Figure 29: Parents’ Perceptions of Child Behavior (2010‐2013) .......................................................................................... 45

Figure 30: Percentage of 3rd Grade Students in the County At / Above Grade Level In English/Language Arts .................. 51

Figure 31: Number of Early Childhood Educators Who Have Completed SEEDS Trainings .................................................. 56

Figure 32: Number of SEEDS‐Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007‐2013) ......................................................................................................................................................... 56

Figure 33: Key Demographics of SEEDS‐Trained Early Childhood Educators in Licensed Programs (2007‐2013) ................ 57

Figure 34: Number of Children Participating in Raising A Reader (2012‐2013) ................................................................... 57

Figure 35: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012‐2013) ........................................................................................................................................ 61

Figure 36: Changes in Students’ Letter Sound Recognition Skills After Participation in the Migrant Education Summer Pre‐K Program (2013) ........................................................................................................................... 61

Figure 37: The Impact of Family Activities on School Readiness .......................................................................................... 62

Figure 38: Percentage of Children Receiving Services from Multiple First 5 Partners ......................................................... 65

Figure 39: Average Cost per Client, by Goal Area and Partner (2012‐2013) ........................................................................ 66

Figure 40: Statement of Activities, Fiscal Year 2012‐2013 ................................................................................................... 67

TABLE OF FIGURES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT

iv FIRST 5 SANTA CRUZ COUNTY

Figure 41: Amount of Leveraged Investments, by Type (2012‐2013) .................................................................................. 68

Figure 42: Total Amount of First 5 and Leveraged Investments (2012‐2013) ...................................................................... 68

Figure 43: Number of 2‐1‐1 Callers, Needs, and Referrals ................................................................................................... 69

Figure 44: Types of 2‐1‐1 Callers’ Needs (2011‐2013) ......................................................................................................... 70

Figure 45: Types of 2‐1‐1 Referrals (2011‐2013) .................................................................................................................. 70

Figure 46: HCOC Child Health Insurance Enrollment, Renewal, and Utilization Percentages .............................................. 75

Figure 47: Newborn Enrollment Project Statistics (2012‐2013) ........................................................................................... 77

Figure 48: Number of Emergency Department Visits (Infants Less Than One Year Old) ..................................................... 78

Figure 49: Demographics of the Children (Ages 0‐5) Participating in the DICDP (2011‐2013) ............................................. 82

Figure 50: Percentage of Children in DICDP (Ages 0‐5) With These Diagnoses and Services, at Intake (2011‐2013) .......... 82

Figure 51: Percentage of Children in DICDP (Ages 0‐5) Provided With These Referrals (2011‐2013) .................................. 83

Figure 52: Case Flow Diagram (2012‐2013) ......................................................................................................................... 85

Figure 53: Percentage of Families Together Participants Who Showed Decreased Risk of Child Maltreatment ................. 86

Figure 54: Change in Families Together Participants’ Risk Levels Over Time (2007/08 ‐ 2012/13) ..................................... 87

Figure 55: Percentage of Families Together Participants Who Do Not Have a Substantiated Allegation of Maltreatment Within 6 Months After Case Closure ........................................................................................... 88

Figure 56: Percentage of Families with Child Welfare Issues Within 6 Months After Exit from Families Together (2012) .. 88

Figure 57: Parents’ Use of Positive Parenting Styles (Families Together: 2010‐2013) ......................................................... 89

Figure 58: Parents’ Perceptions of Child Behavior (Families Together: 2010‐2013) ............................................................ 89

Figure 59: Parents’ Satisfaction with Various Aspects of the Triple P Program (Families Together: 2010‐2013) ................ 90

Figure 60: Demographics of Triple P Parents/Guardians (2010‐2013) ............................................................................... 102

Figure 61: Ages of Children Chosen as the “Index” Child (2010‐2013) .............................................................................. 102

Figure 62: Types of Triple P Services Provided ................................................................................................................... 103

Figure 63: How Participants First Heard about Triple P (2010‐2013) ................................................................................. 104

Figure 64: Number of Parents (with Unique IDs) Who Participated in One or More Type of Triple P Service (2010‐2013) ....................................................................................................................................................... 105

Figure 65: Matrix of Parents (with Unique IDs) Who Participated in Multiple Types of Services (2010‐2013) .................. 106

Figure 66: Percentage of Parents Who Completed Their Multi‐Session Triple P Services (2010‐2013) ............................. 106

Figure 67: Parents’ Satisfaction with the Triple P Program: Levels 3 (Individual or Brief Group), and Levels 4 and 5 (2010‐2013) ....................................................................................................................................................... 108

Figure 68: Parents’ Satisfaction with the Triple P Seminars/Workshops (2010‐2013) ...................................................... 108

Figure 69: Number and Types of Organizations with Accredited Triple P Practitioners, by Triple P Level (2012‐2013) .... 109

Figure 70: Number of Accredited Triple P Practitioners .................................................................................................... 109

Figure 71: Types of Triple P Services Provided (LMCR: 2012‐13) ....................................................................................... 112

Figure 72: Increases in Positive Parenting (LMCR: 2010‐2013) .......................................................................................... 113

Figure 73: Parents’ Use of Positive Parenting Styles (LMCR: 2010‐2013) .......................................................................... 114

Figure 74: Parents’ Perceptions of Child Behavior (LMCR: 2010‐2013) ............................................................................. 115

Figure 75: Parents’ Satisfaction with Various Aspects of the Triple P Program (LMCR: 2010‐2013) ................................. 117

Figure 76: Types of Triple P Services Provided (MCR: 2012‐13) ......................................................................................... 119

Figure 77: Parents’ Use of Positive Parenting Styles (MCR: 2010‐2013) ............................................................................ 120

Figure 78: Parents’ Perceptions of Child Behavior (MCR: 2010‐2013) ............................................................................... 121

Figure 79: Parents’ Satisfaction with Various Aspects of the Triple P Program (MCR: 2010‐2013) ................................... 122

Figure 80: Percentage of Center‐Based Children Who Made Developmental Changes in Key Social and Pre‐Literacy Measures .......................................................................................................................................................... 133

Figure 81: Number of SEEDS‐Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007‐2013) ....................................................................................................................................................... 139

Figure 82: Key Demographics of SEEDS‐Trained Early Childhood Educators in Licensed Programs (2007‐2013) .............. 140

Figure 83: Preschool Classrooms of SEEDS Plus participants: Support for Language and Literacy (2012‐2013) ................ 141

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT TABLE OF FIGURES

FIRST 5 SANTA CRUZ COUNTY v

Figure 84: Preschool Classrooms of all SEEDS‐Trained Early Childhood Educators: Key Language and Literacy Supports (2007‐2013) ....................................................................................................................................... 142

Figure 85: Family Child Care Settings: Support for Language and Literacy (2012‐2013) ................................................... 144

Figure 86: SEEDS Plus Classrooms: Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012‐2013) ...................................................................................................................................... 145

Figure 87: SEEDS Plus Classrooms: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012‐2013) ........................................................................................ 146

Figure 88: SEEDS Plus Classrooms: Percentage of Children at Each Target Level in Five Pre‐Literacy Skill Areas, in English (2012‐2013) .......................................................................................................................................... 147

Figure 89: Reading Corps Classrooms: Percentage of Children At/Above Targets for Later Reading Success, in English (2012‐2013) .......................................................................................................................................... 150

Figure 90: Reading Corps Classrooms: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, in English, Entire Classroom (2012‐2013) .............................................................................. 151

Figure 91: Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012‐2013) ....... 152

Figure 92: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012‐2013) .................................................................................................................... 153

Figure 93: Percentage of Children at Each Target Level in Five Pre‐Literacy Skill Areas, in English (2012‐2013) ............... 153

Figure 94: Summer Pre‐K Academy Letter Sound Recognition Results (2013) .................................................................. 158

Figure 95: Percentage of Summer Pre‐K Academy Students who Increased Their Letter Sound Recognition By At Least 5 Letter Sounds ................................................................................................................................... 158

Figure 96: Average Increase in the Number of Letter Sounds Recognized by Summer Pre‐K Academy Students ............. 158

Figure 97: Number of Child Snapshot Forms Collected from Participating Preschool Programs ....................................... 160

Figure 98: Demographics of Children with Child Snapshots .............................................................................................. 160

Figure 99: Percentage of Children With These Health and Academic Issues ..................................................................... 161

Figure 100: Percentage of Children Who Received Health or Developmental Assessments in the Past Year ..................... 161

Figure 101: The Impact of Family Activities on School Readiness ........................................................................................ 162

Figure 102: Responses to Key Questions from the Child Snapshot Kindergarten Teacher Survey ...................................... 164

TABLE OF FIGURES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT

vi FIRST 5 SANTA CRUZ COUNTY

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT EXECUTIVE SUMMARY

FIRST 5 SANTA CRUZ COUNTY 1

EXECUTIVE SUMMARY

EXECUTIVE SUMMARY FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT

2 FIRST 5 SANTA CRUZ COUNTY



First 5 Santa Cruz County’s Mission:

To help children succeed in

school and in life, First 5 Santa

Cruz County invests in health,

early learning, and family

support to promote optimal

development of Santa Cruz

County children.

First 5 Santa Cruz County’s Vision:

All Santa Cruz County

children enter school

ready to achieve to their

greatest potential.

EXECUTIVE SUMMARY

The Importance of Investing in Young Children

A growing body of scientific evidence points to the economic and societal impacts of wise

investments in the early years. The Harvard Center for the Developing Child states:

A vital and productive society with a prosperous and sustainable future is

built on a foundation of healthy child development. Health in the

earliest years lays the groundwork for a lifetime of vitality.

Experiences during the first few years of life – good and bad –

literally shape the architecture of the developing brain. Stable,

positive relationships with adults and growth‐promoting experiences

are keys to the development of the architecture that forms the

foundation for all future learning, behavior, and health. When we

invest wisely in children and families, the next generation will pay that

back through a lifetime of productivity and responsible citizenship.1

First 5 Santa Cruz County is dedicated to giving children the

opportunities they need to reach their full potential.

Overview of this Report

The Strategic Plan for 2012‐2015 articulates community goals

and results in goal areas of Healthy Children, Strong Families,

Children Learning and Ready for School, and Family Friendly

Integrated Services.

This annual report summarizes findings of the First 5 Santa Cruz

County evaluation from July 1, 2012 to June 30, 2013. Many programs

are multi‐year investments, and therefore some information presented

reflects multiple years of data.

Overall Well-Being of Children in the County First 5 Santa Cruz County invests in health, early learning, and family support to promote the well‐

being of children. To help guide its investments and partnerships, First 5 monitors county‐wide

trends that affect child well‐being. The year 2012‐2013 marks the first year of the 2012‐2015

strategic plan, and the following data reflect the current status of the County:

Santa Cruz County has a growing and diverse population of young children. In 2013, there

were 18,753 children ages 0‐5 in Santa Cruz County, the majority of whom were either

Hispanic (55%), or White (37%). This diversity continues into kindergarten, where in 2013

almost 47% of children had a primary language other than English.

1 http://developingchild.harvard.edu



“Between 2007 and

2010, nearly half a

million California

children lost private

health insurance.”

- Children Now, 2012 <http://www.childrennow.org>

Unemployment has grown dramatically and still varies greatly across the County. The

County’s unemployment rates reflect the broader economic recession and slow recovery.

Over the past five years the unemployment rate for the County has increased, but has fallen

1.3% just during the last year, with a current unemployment rate in the County of 10%.

Within the County, the percent of unemployed residents differed greatly by area; the

average 2013 unemployment rate (as of July) ranged from 4% in Aptos to 21% in Watsonville.

There was rising enrollment in public assistance programs. Over the last five years, with

increased outreach and program design changes, there was an 81% increase in the number

of residents participating in CalFresh (Food Stamps). Between 2007 and 2012, the total

number of County residents participating in CalWORKS increased 5%, and there was an

increase in the number of County residents participating in the National School

Lunch Program (23% increase), and the Women, Infants, & Children Program

(3% increase).

Enrollment in publicly‐funded health insurance programs has

increased. Over the last five years, enrollment in Medi‐Cal increased 14%,

with an increase of 6% in just the last year. Decreased enrollment in

Healthy Families reflects the efforts that began in January 2013 to move all

children enrolled in the Healthy Families Program into the new coverage

provided by Medi‐Cal known as Targeted Low‐income Children’s Program (“Medi‐Cal

TLC” or “Medi‐Cal for Families”). Enrollment in Healthy Kids has also decreased (potentially

due to children’s increased eligibility for coverage by Medi‐Cal TLC).

Not enough young mothers are receiving prenatal care in the first trimester. In 2012, the

percentage of mothers who received prenatal care in their first trimester was high – 82% —

which exceeded the Healthy People 2020 target rate of 78%. However, younger mothers

(ages 24 and younger) tended to fall below this target rate, with only 70% receiving first

trimester care.

Additionally, there were differences in receipt of early prenatal care based upon the

mother’s source of payment for the care. Only 74% of mothers with Medi‐Cal began receiving

prenatal care during the first trimester, compared to 92% of mothers with private insurance.

The percentage of births to teen mothers in the County is slowly decreasing. In 2012, the

percentage of births to teen mothers represented 7% of all births in Santa Cruz County, and

there was a teen birth rate of 21 per 1,000 (ages 15‐19). Between 2007 and 2012 there was a

slight decrease both in births to teen mothers and in the teen birth rate. Taken together, the

two measures indicate a slowly decreasing proportion of teens in the County who are

becoming mothers.

Over half of the births by women in the County were paid for by Medi‐Cal. In 2012, 52% of

births, across all age groups, were paid for by Medi‐Cal. However, Medi‐Cal was utilized by

almost 82% of the births to women under the age of 25.



A Profile of First 5 Participants

First 5 Santa Cruz County reaches children who can make great gains with early and smart investments.

First 5’s goal is to serve the most vulnerable children ages 0‐5 and their families in Santa Cruz

County, including very low‐income families, English language learners, and families who live in

higher risk zones of the County.

First 5‐supported programs are wide‐reaching: In 2012‐13, First 5 partners served 7,966

children ages 0‐5 (unduplicated), representing 42% of all children these ages in Santa Cruz

County.

First 5 serves a high number of dual language learners: Of the children served by First 5, 79%

were Latino, and 64% of participants spoke Spanish in their household. Of all Latino children

ages 0‐5 in Santa Cruz County, 59% participated in services funded by First 5.

First 5 is serving children in the highest risk zones of the County. Of the children served who

had known ZIP codes, most (91%) lived in the areas of the County that rank highest on a

cumulative index of risk factors that included measures of linguistic isolation, family income,

birth statistics, parental education attainment, child maltreatment and family violence. These

areas include Watsonville, Freedom, Live Oak, and some areas in the city of Santa Cruz.

First 5 strengthens systems by enhancing the capacity of service providers

In addition to supporting direct services to children and families, First 5 aims to boost the capacity of

local systems in order to extend the reach of critical early education, family support, and health

services to a larger number of children and families. Systems enhancements help ensure better

services for years to come.

Examples of First 5’s capacity‐building work in 2012‐2013 include:

Skill development and coaching for early childhood educators. Training of 138 early

childhood educators from preschools and family child care homes who received professional

development training from the SEEDS of Early Literacy or Race to the Top programs.

Approximately 50 early childhood educators received professional development trainings

through the Child Signature Program, and 40 staff/child care providers received training from

Side‐by‐Side Clinician/Consultants;

Development of a population‐based system of parent education. Training of 19 parent

education practitioners to deliver the Triple P curriculum, an evidence‐based curriculum

shown to improve parental efficacy, parent‐child interaction, and child behaviors;



Since 2004, 11,410 children

ages 0‐5 have been enrolled

in public health insurance.

In 2012‐13, nearly all mothers

(99.8%) who were assisted

with their Medi‐Cal

applications had their new

babies enrolled in Medi‐Cal.

Support for children’s transition to kindergarten. Participation of teachers in 40 preschools

to prepare Child Snapshots, a transcript of parent information and child skills that is delivered

to children’s kindergarten classrooms. The Child Snapshot supports children’s transition to

kindergarten by involving parents in the process and providing important information that

helps kindergarten teachers prepare for their incoming students.

Distribution of information to community service providers. Training of health, social

services, and early education providers through workshops, Brown Bag Lunches, and other

trainings to better integrate services and improve customer service.

Healthy Children

For the past several years, First 5 Santa Cruz County has invested in strategies to help ensure that all

children have access to care. Though coverage rates are high in the County, there are still children

who do not have health insurance.

First 5 Santa Cruz County insures children

First 5 helps uninsured children enroll in health plans: In 2004, First 5 Santa Cruz County

helped create a new children’s health initiative called Healthy Kids. Healthy Kids has Certified

Application Assisters who provide outreach and assistance to income‐eligible families to help

them apply for public health insurance, and to renew their coverage annually. Because Medi‐

Cal and Healthy Families cannot cover all of the uninsured, First 5 also funds the premiums

for Healthy Kids members.

Children are getting enrolled in public health insurance plans. Since the start of the Healthy

Kids Initiative (June 1, 2004‐June 30, 2013), there were 1,345 new enrollments of children

ages 0‐5 in the local Healthy Kids program, 3,870 children in Healthy Families, and 6,195

children in Medi‐Cal, for a total of 11,410 new enrollments of children ages 0‐5.

Children are renewing and using their health insurance. In order to ensure continuity of

care, it’s important that parents keep their children enrolled in health insurance plans.

During the 2012‐13 funding cycle, the Certified Application Assisters

helped ensure that 92% of children ages 0‐5 renewed their

membership in public health insurance. Nearly all children

(99%) who renewed in public health insurance had utilized

care prior to renewal.

The large increase in Medi‐Cal re‐enrollments reflects the

efforts that began in January 2013 to move all children

enrolled in the Healthy Families Program into the new

coverage provided by Medi‐Cal known as Targeted Low‐income

Children’s Program (“Medi‐Cal TLC” or “Medi‐Cal for Families”).



Santa Cruz County’s newborns are getting connected to medical care. During 2012‐13, Baby

Gateway—the Newborn Enrollment Project—provided 73% of all mothers with a newborn

visit while in the hospital. Baby Gateway also assisted 83% of all mothers with Medi‐Cal births

to complete a Medi‐Cal application for their new babies. Of those assisted, nearly all (99.8%)

had their new babies enrolled in Medi‐Cal, and 94% were assigned a primary care provider

for their child.

First 5 Santa Cruz County supports children to get a medical home, preventive care, and dental care

Children have a medical home. Nearly all children (97%) ages 2‐6 who were enrolled in Healthy

Kids had access to a primary care practitioner, according to the 2012 HEDIS measures.2 The

majority of children (ages 3‐6) in Healthy Kids also had a well‐child visit (85%).

Fewer children are using the emergency department (ED). Ideally, children and their families

who have insurance and who have a medical home will be more likely to access their

provider for routine preventive care, and less likely to use the emergency department (ED)

for non‐urgent medical care.

o Results from the California Health Interview Survey (CHIS) show that the percentage of

County children ages 0‐5 who visited the ED during the year has decreased 16% between

2007 and 2012.

o The services provided by the Newborn Enrollment Project may also have had an effect on

the use of the ED for very young infants. Since the launch of this program at each hospital,

the number of infants (less than one year old) who visited the Emergency Department

dropped 36% at Watsonville Community Hospital (since 2009), and 5% at Dominican

Hospital (since 2011).

Children are getting dental care. In 2011, 84% of families surveyed as part of the Community

Assessment Project said that at least one of their children ages 0‐5 had dental insurance. In

2011‐12, CHIS data reported that 83% of children ages 0‐5 had a dental visit in the past year.

Children are getting support to reach developmental milestones. Foster children with

neurodevelopmental needs are getting referred to supportive services through Dominican

Pediatrics’ coordinated and multidisciplinary system called the Dominican Interdisciplinary

Child Development Program (DICDP).

2 HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures used by the Health Care Quality Measurement (HCQM) annual report to track the quality of care that children enrolled in Healthy Kids are receiving in Santa Cruz County. HEDIS results are analyzed for the calendar year; therefore, 2012 results are for the time period January 1 ‐ December 31, 2012.



At‐risk parents have improved

parenting styles and reduced

risk of maltreatment.

The percentage of Families

Together participants assessed

as being at high risk or very

high risk of child maltreatment

dropped from 61% to 12%.

Strong Families

Santa Cruz County historically has had higher rates of child abuse and neglect than any other Bay

Area county.3 Fortunately, the rates of child maltreatment are decreasing and in 2012, the County

rate of substantiated allegations of child maltreatment (8.0 per 1,000) dropped lower than the

state‐wide rate (9.3 per 1,000) for the second time since 2004.

First 5 Santa Cruz County helps strengthen parent‐child relationships and reduce risk for child abuse and neglect

Through innovative programs, First 5 and its partners are helping to decrease the risk and incidence

of child abuse and neglect.

In partnership with the County’s Human Services Department‐Family and Children’s Services

and Encompass Community Services (formerly Santa Cruz Community Counseling Center),

First 5 supports a program called Families Together. Families Together is Santa Cruz County’s

differential response program, a strategy used to intervene early with families in

which there has been an allegation of abuse. This home visiting program

includes comprehensive intake and risk assessment, development of a

tailored case plan, parent support and education, child development

activities, and periodic assessments. Results of the program have

been very encouraging:

○ Reduction of risk. Parents/primary caregivers receiving

services from Families Together had their levels of risk assessed while

they were in the program. Pre and post risk assessments for several

years combined indicated that families reduced their level of risk for

future maltreatment.

o Reduced rates of child maltreatment. Results indicate that although some families are re‐

referred to child welfare after exiting from Families Together, the rate of substantiated abuse

is low. This suggests that even though families are still experiencing high risk factors that lead

to a child welfare report, they may have gained skills and resources during their participation

in Families Together that prevent court‐mandated involvement with child welfare.

First 5 continued the implementation of the Positive Parenting Program, or Triple P. The

program consists of five levels of intervention, from broad‐based, universal efforts in the

community to more intensive, focused efforts with individual parents. The Triple P model is

an evidence‐based program shown in numerous randomized studies to increase parental

confidence and efficacy, promote positive parent‐child interactions and child behaviors, and

reduce rates of child maltreatment.

3 Center for Social Services Research, School of Welfare, U.C. Berkeley. Child Welfare Dynamic Report System, A California Department of Social Services / University of California at Berkeley collaboration, 2013.



Parents are more

confident in their

parenting skills, are

helping to improve their

children’s behavior, and

are building positive

relationships with their

families.

Highlights of this program include:

o Evidence‐based parenting support is available. First 5 has implemented all five levels of

Triple P in Santa Cruz County, from the launch of a media campaign to intensive and focused

individual services. Between 2010 ‐ 2013, approximately 4,324 parents with 7,714 children

participated in the program.

o Parents are engaged and seek more opportunities. Of parents who participated in the

Seminars and Workshops, 22% requested follow‐up services, suggesting that these brief

services may be an effective way of getting parents engaged in the program and gives

them an opportunity to participate in further services. New studies also suggest that

clients who begin in a Triple P program that requires a high level of commitment and time

continue to feel engaged and are interested in continuing their participation, either

returning for a quick lesson on a specific topic, or to continue in‐depth parent education

and skills training.

o Parenting skills and knowledge are improving along several domains. Parents who

participated in Levels 3 and 4 of the Triple P program completed assessments that measured

their levels of parenting skills and knowledge along several domains.

Results showed significant improvements in all domains,

including:

Increased use of positive parenting styles Improved

levels of confidence in parenting Reduced levels of

conflict over parenting Increased support in their

role as a parent Increased levels of satisfaction

with their relationship with co‐parents Decreased

levels of emotional difficulties Improvements in child

behavior

o Parents with more serious parenting issues are making the greatest improvements.

There was also evidence that parents who began the program with more serious

parenting issues demonstrated the greatest improvements as a result of receiving in‐

depth services (8 or more sessions). This was particularly true for parents in Teen Triple P.

o Parents are satisfied with services. Parents have rated the quality of services very high, noting

that they had received the help they wanted, were dealing more effectively with problems in

their family, and would come back to the program if they needed to seek help again.

o Parents are continuing to use the skills they learned. On average, parents felt that the

Seminars and Workshops answered their questions, and that they would continue to use

the strategies they learned.

Provision of early mental health services. The Side‐by‐Side program was created to address

the significant need for early mental health services for families with children ages 0‐5.

Results indicate that children are greatly benefiting from their participation in family services,

and 100% of families that participated in 8‐12 psychotherapy/counseling meetings and

completed pre/post assessments reported improvement in their children’s behavior.



Children Learning and Ready for School

First 5 is helping to improve the quality of early learning programs in Santa Cruz County

In 2012‐13, First 5 Santa Cruz County launched its Quality Early Learning Initiative (QELI) in

collaboration with local partners, with the goal of improving the quality of early learning programs in

Santa Cruz County. First 5 established this initiative as a result of receiving funding through

California’s Race to the Top ‐ Early Learning Challenge (RTT‐ELC) federal grant, and First 5 California’s

Child Signature Program (CSP), which share a common goal of increasing the quality of early learning

programs and closing the achievement gap for vulnerable young children.

A consortium of local partners is implementing a county‐wide plan to improve the quality

of early learning programs. First 5 established the Santa Cruz County Quality Early Learning

Initiative (QELI) Consortium, which created a county‐wide Quality Improvement Plan (QIP),

and adopted a local Quality Rating and Improvement System (QRIS) as a way to foster

ongoing improvement of early care and education programs in Santa Cruz County.

Baseline ratings and trainings are beginning. During this past year, the Early Learning System

Specialist (ELSS) completed Readiness Assessments with all CSP classrooms, coordinated trainings

related to CSP and RTT‐ELC, provided technical assistance to program directors, developed

processes for maintaining centralized records, and began conducting the QRIS baseline ratings.

Local QELI resources are leveraged through participation in regional partnerships. Santa

Cruz County has joined a regional consortium so that these neighboring counties could

strategize together, share resources, leverage funds, and align practices. The counties in this

consortium will also develop and share a common data system called the Bay Area Regional

RTT Database, which will gather scoring information and review progress in relation to the

Consortium’s local quality improvement targets.

A model infant/toddler quality site serves as a “learning community” that promotes early

literacy and social/emotional skills critical for school success. The Starlight Children’s Center

(SCC) is a new program for families of children 0‐3 years old, with the key goal of creating a

“learning community” that promotes early literacy and social/emotional skills. Assessment results

from the DRDP‐I/T show that toddlers in the Starlight Children’s Center are being supported to

develop social and interpersonal skills, and to develop a strong foundation for later literacy.

First 5 Santa Cruz County builds early literacy foundations by training early childhood educators to enhance language‐rich practices in the classroom

One of the most powerful indicators of later success is a child’s reading proficiency at the end

of 3rd grade,4 and data show that Santa Cruz County children are struggling with their reading

4 Kidsdata.Org, Lucile Packard Foundation for Children's Health, Reading Proficiency, retrieved from http://www.kidsdata.org/, 2013.



392 early child

educators are now

promoting strong

language and

literacy foundations

for children.

“The seeds of literacy are

planted before children

enter school.

Important literacy skills do

not develop spontaneously,

instruction shapes them.”

- Snow, Burns, & Griffin, 1998

skills. For example, only 36% of 3rd grade students in the County scored proficient or better

on the standardized California English Language Arts test (STAR5) in 2013.

The good news is that one area of the county with historically low performance has shown

particularly great improvements in scores. In the past five years, Pajaro Valley Unified School

District’s English/Language Arts scores increased 4%, and Freedom Elementary’s scores (a

school within the PVUSD) increased 16%.

First 5 Santa Cruz County is helping to improve children’s school

performance by encouraging families to read together, providing language

and literacy skill development for early childhood educators, encouraging

child assessments and individualized instruction, and working to help

children smoothly transition into kindergarten.

The SEEDS of Early Literacy curriculum is being used throughout

Santa Cruz County child care programs and preschools. Since the founding of

the Early Literacy Foundations Initiative in 2006‐07, 207 teachers and coaches

working in state‐ and federally‐subsidized classrooms have been SEEDS‐trained.

Additionally, there are 185 SEEDS‐trained licensed family child care providers, teachers, and

coaches in private and non‐profit centers/homes, 155 Family, Friend or Neighbor (FFN)

informal child care providers, and 12 Reading Corps tutors who received SEEDS training.

Classrooms and home‐based settings of SEEDS‐trained early educators are being

transformed into literacy‐rich environments. SEEDS‐trained early childhood educators are

working to ensure their children are on target for kindergarten readiness by using evidence‐

based early literacy strategies, receiving on‐site coaching, and integrating materials into their

learning environments. Assessment results are showing that SEEDS‐trained

and coached teachers are improving the quality of support they provide

in their classrooms for children’s development of early literacy:

o In preschool classrooms taught by SEEDS Plus participants, results

from the Early Language and Literacy Classroom Observation tool

show that in 2012‐13, the percentage of classrooms that provided

high quality support for early literacy increased from 67% at pre‐

assessment to 100% at post‐assessment.

o In home‐based settings, results from the Child/Home Early Language and Literacy

Observation tool indicate that in 2012‐13, the percentage of family child care settings that

were rated as having high quality support for early literacy increased from 50% to 92%.

5 Standardized Testing and Reporting (STAR).



First 5 Santa Cruz County helps children build the foundation for later reading success

Parents are getting involved in their children’s reading. SEEDS classrooms also implemented

Raising A Reader, a weekly rotating book bag program for families, to boost shared reading

practices and impact children’s early literacy skills. In the 2012‐13 fiscal year, 4,556 children

and their families participated in the program.

Children are developing skills in key areas of reading success. Many preschool classrooms

throughout the County are taught by teachers who have received SEEDS training funded by

First 5. Results show that children benefit when teachers enhance their skills to promote

early literacy and use Response to Intervention (RtI) strategies with children needing the

biggest boost in key early literacy areas.

o In State Pre‐K classrooms:

When teachers used child assessment data to tailor their instruction with children,

children in these SEEDS‐trained classrooms increased their skills in all five pre‐literacy

skill areas.

Focus on English skills. During this pilot year of the Santa Cruz Reading Corps, 12

Preschool Literacy Tutors were trained in research‐based strategies following the

SEEDS of Early Literacy curriculum, and were placed in 23 State Preschool classrooms.

All children in these classrooms showed improvement in all five pre‐literacy skill

areas—in English—no matter what their primary language was, and Spanish‐speaking

children particularly demonstrated improvement in their English language skills.

o In the Summer Pre‐K Academy:

Children are learning letter sounds. In 2013, 116 children—with little to no prior

preschool experience—participated in the 4‐week Migrant Education Summer Pre‐K

program. Of those who participated in at least 14 sessions, 87% increased their letter

sound recognition by at least five letter sounds, and on average, they learned to

recognize 15 new letter sounds by the time they left the program.

First 5 Santa Cruz County helps children successfully transition to kindergarten

First 5 is investing in activities that help children successfully transition to kindergarten. Some ways

to do this are to encourage parents to visit the new school with their child, to meet the new

kindergarten teacher, and to attend parent orientations. The following highlights First 5’s work to

support successful transitions to kindergarten:

First 5 Santa Cruz County is working with parents and early childhood educators to create

an information “bridge” for children as they transition to kindergarten. First 5 Santa Cruz

County continued to support the use of the Child Snapshot as a vehicle for communication

among kindergarten, preschool, and family child care teachers about children who are



transitioning to kindergarten. The Child Snapshot supports children’s transition to

kindergarten by involving parents in the process and providing important information that

helps kindergarten teachers prepare for their incoming students.

o This spring, teachers and parents at 40 preschools completed individual Child Snapshot

forms for 906 children, which were then collected and shared with kindergarten teachers

at 53 elementary schools in Santa Cruz County and surrounding areas.

o In 2012‐13, new analyses were performed to determine if any of the family activities

noted in the Child Snapshot were correlated with children’s school readiness skills. Results

revealed some statistically significant relationships between certain family activities (e.g.,

singing and telling stories, eating family meals together, visiting the library, and playing

games together) and improved school readiness skills.

o Results from a Kindergarten Teacher Survey indicated that 92% of kindergarten teachers

used Child Snapshots in some way to assist with their incoming students' transition to

kindergarten. The Child Snapshot helped kindergarten teachers with three key transition

elements: Communicating with parents; Preparing for the incoming students; Forming

balanced kindergarten classes.

Parents are receiving kindergarten transition information. Approximately 301 parents

participated in Transition to Kindergarten Workshops where they learned about kindergarten

registration requirements, choices of language programs, how to support their child in

school, and ways to ensure that their child’s entry into school is a pleasant and smooth

transition.

Service Integration & Community Strengthening

First 5 efforts are sustainable

Partners maximize First 5 investments by leveraging these funds to draw down other matching

funds. In 2012‐13, First 5 Santa Cruz County had a total annual program investment of

$4,045,835, and First 5 partners leveraged an additional $2,339,891.

2‐1‐1 is a centralized point of contact for Santa Cruz County residents to get information on

local services, and is operated by the United Way of the Bay Area and funded by several local

agencies including First 5 Santa Cruz County. Since the 2‐1‐1 program began in Santa Cruz

County in 2010, a total of 14,434 people have called, with a total of 18,678 needs and 23,194

referrals. Results show how effective this program has been in helping residents with their

everyday needs and concerns, and during emergency situations.



Summary

First 5 Santa Cruz County is serving 42% of children ages 0‐5 in Santa Cruz County, and they are

serving the most vulnerable children, including those in families that are experiencing severe

poverty and are living in areas of the County with the highest risk factors.

First 5 and its partners are achieving results in helping these very vulnerable children and families:

In the Healthy Children goal area, data show that children are insured and using preventative

health care:

o Since 2004, 11,410 children ages 0‐5 have been enrolled in public health insurance.

o In 2012, 97% of children (ages 2‐6) in Healthy Kids had a medical home, and 85% of

children (ages 3‐6) had a well‐child visit in the last year.

o In 2012‐13, Baby Gateway assisted 83% of all mothers with Medi‐Cal births to complete a

Medi‐Cal application for their new babies. Of those assisted, nearly all (99.8%) had their new

babies enrolled in Medi‐Cal, and 94% were assigned a primary care provider for their child.

o Foster children with neurodevelopmental needs are getting referred to supportive

services through Dominican Pediatrics’ coordinated and multidisciplinary system called

the Dominican Interdisciplinary Child Development Program (DICDP).

In the Strong Families goal area, families are becoming more healthy and resilient, and it

benefits their children:

o Families who are at risk for child abuse and neglect are being helped to reduce that risk.

o 95% of families who received services from the Families Together program had no

substantiated allegations of maltreatment in the six months after their cases closed.

o First 5 has implemented all five levels of Triple P in Santa Cruz County, from an expanded

social marketing campaign to intensive and focused individual services. Brief services may

be an effective way of getting parents engaged in the program and provide an opportunity

to participate in further services.

o Parents participating in the Triple P parenting program significantly increased their

confidence in parenting, used more positive parenting styles, felt more supported, and

improved their relationships with their families.

o Parents who began the program with more serious parenting issues demonstrated the

greatest improvements as a result of receiving in‐depth services (8 or more sessions).

o Parents in Teen Triple P tended to report more serious parenting issues than parents in Core

Triple P, and demonstrated a greater degree of improvement by the end of the program.

o Early mental health services are being provided. Of families that participated in 8‐12

psychotherapy/counseling meetings and completed pre/post assessments, 100% reported

improvement in their children's behavior.



In the Children Learning and Ready for School goal area, data show that First 5 is successfully

improving the quality of early learning programs and building teacher skills to develop

children’s early literacy skills:

o In 2012‐13, First 5 Cruz County launched its Quality Early Learning Initiative (QELI) in

collaboration with local partners, with the goal of improving the quality of early learning

programs in Santa Cruz County, and closing the achievement gap for vulnerable young

children.

o A model infant/toddler quality site is serving as a “learning community” that promotes

early literacy and social/emotional skills critical for school success. Assessment results

show that toddlers in the Starlight Children’s Center are being supported to develop social

and interpersonal skills, and to develop a strong foundation for later literacy.

o The SEEDS of Early Literacy approach is transforming early education settings in the

County. In 2012‐13, the percentage of preschool classrooms taught by SEEDS Plus

participants assessed as providing high quality literacy support for children increased from

67% to 100%. Similarly, the percentage of family child care settings that were rated as

having high quality support increased from 50% to 92%.

o Children in SEEDS‐trained classrooms are developing skills in key areas of reading success.

Many State Preschool classrooms are taught by teachers who have received SEEDS

training, and during this pilot year of the Santa Cruz Reading Corps, 12 Preschool Literacy

Tutors with SEEDS training were placed in 23 of these classrooms. Children in these

classrooms showed improvement in all five pre‐literacy skill areas—in English—no matter

what their primary language was, and Spanish‐speaking children particularly

demonstrated improvement in their English language skills.

o The Child Snapshot supported 906 children with their transition to kindergarten by

involving parents and preschool teachers in the process, and providing important

information that helped kindergarten teachers prepare for their incoming students. New

studies revealed some statistically significant relationships between certain family

activities and improved school readiness skills, and 92% of kindergarten teachers used the

Child Snapshot to assist with their incoming students' transition to kindergarten.

First 5 partners are maximizing First 5 funding by leveraging their funds to bring in an

additional 2.3 million dollars. Because of First 5’s funding and this kind of additional support,

Santa Cruz County children will continue to get the support they need to become healthy,

strong, and ready for school.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS


PART 1: STRATEGIC FRAMEWORK RESULTS

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT


FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS


First 5 Santa Cruz County’s Strategic Framework

First 5 Santa Cruz County has the great privilege and responsibility to act as the steward of

Proposition 10 (“tobacco tax”) resources for young children from prenatal to age 5 in Santa Cruz

County. Since its inception, the Commission has worked to establish a legacy through building a

coordinated and integrated system of care and support for children 0‐5 and their families.

The First 5 Santa Cruz County Commission utilizes the strategic framework shown below to guide its

funding and programmatic decisions. This enables First 5 to allocate its resources effectively and

measure the impact of its investments. See Appendix A for a detailed version of this framework.

Preview of the Strategic Framework Section of this Report

The Strategic Framework is also the framework for the evaluation. Thus, the Strategic Framework

section of this report reviews the progress that has been made between July 1, 2012 and June 30,

2013 toward achieving the specific results in each of the goal areas. Multiple years of data are often

shown for programs and initiatives for which there have been multiple years of investment. To

contextualize these outcome data, this section begins with a review of county‐wide trends as well as

a profile of First 5’s participants, and concludes with a section regarding First 5 Santa Cruz County’s

efforts to support service integration and community strengthening.

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT


FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS COUNTY TRENDS


Overall Well‐Being of Children in the County

A Profile of Santa Cruz County’s Youngest Children

Santa Cruz County has a diverse population of young children. In 2013, there were 18,753 children

ages 0‐5, the majority of whom were either Hispanic (55%), or White (37%). This diversity continues

into kindergarten, where in 2013 almost 47% of children had a primary language other than English.

Figure 1: Number of County Children ages 0-5

Figure 2: Ethnicity of County Children ages 0-5 (2013)

Figure 3: English Language Proficiency of County Kindergarteners (2012-13)

Source: (Population and Ethnicity; 2006 – 2009) State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail, 2000–2010. Sacramento, California, September 2012; (Population and Ethnicity; 2010 – 2013) State of California, Department of Finance, Report P‐3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010‐2060. Sacramento, California, January 2013; (English Language Proficiency) California Department of Education, DataQuest, 2012‐13.

N: (Ethnicity) N=18,753; (English Language Proficiency) N=3,219.

18,571 18,489 18,518 18,360 18,046 18,327 18,633 18,753

10,000

14,000

18,000

22,000

2006 2007 2008 2009 2010 2011 2012 2013

55.3%

36.7%

2.4%

0.8%

4.8%

Hispanic

White

Asian/ Pacific Islander

Other

Multirace

53.1%

1.2%45.7%

English as PrimaryLanguage

Fluent‐English‐Proficient (FEP)

English Learners (EL)

OVERALL WELL-BEING OF CHILDREN IN THE COUNTY

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT COUNTY TRENDS


County-Wide Trends in Indicators of Child and Family Well-Being

INDICATOR COUNTY POPULATION CURRENT DATA

1

CHANGE OVER TIME2

1 YEAR 5 YEARS

EMPLOYMENT

Unemployment Rate

Santa Cruz County 9.9% ‐1.3% +2.6%

Watsonville 20.9% ‐2.3% +4.9%

Aptos 3.9% ‐0.5% +1.1%

PUBLIC ASSISTANCE

CalWORKS enrollment General population (Enrollment as of July of each year)

4,798* ‐0.5% +4.6%

CalFresh enrollment (Food Stamps)

General population (Average monthly enrollment)

22,581 +8.0% +80.5%

National School Lunch Program enrollment

Student population (Annual enrollment)

20,290* +2.2% +23.0%

Women, Infants, & Children Program (WIC) enrollment

General population (Average monthly enrollment)

9,629* +0.9% +3.4% (3 year trend)

PUBLIC HEALTH INSURANCE

Medi-Cal enrollment General population (Enrollment as of July of each year)

45,019 +5.6% +14.3%

Healthy Families enrollment Children 0‐18 (Enrollment as of June of each year)

1,686 ‐75.5% ‐71.2%

Healthy Kids enrollment

Children 0‐18 (Enrollment as of June of each year)

1,415 ‐18.3% ‐35.4% (4 year trend)

Children 0‐5 (Enrollment as of June of each year)

134 ‐18.8% ‐49.4% (4 year trend)

PRENATAL CARE IN THE FIRST TRIMESTER

Prenatal Care in the First Trimester (by Mother’s Age)

All Mothers 82.1%* +0.4% +2.6% (3 year trend)

Mothers (ages 24 and under) 70.1%* +2.1% ‐0.6% (3 year trend)

Prenatal Care in the First Trimester (by Payment Method)

Private insurance 92.3%* ‐0.3% +1.3%

Medi‐Cal insurance 73.8%* ‐1.2% +2.8%

TEEN PREGNANCY

Percentage of Births to Teen Mothers

Teen mothers (ages 19 and under) 7.3%* ‐0.6% ‐1.2%

Teen Birth Rate (per 1,000) Teen mothers (ages 15‐19) 20.7* ‐0.9% ‐1.6%

BIRTHS PAID BY MEDI-CAL

Births Paid by Medi-Cal All Mothers 51.9%* ‐1.5% +0.5%

(3 year trend)

Mothers (ages 24 and under) 81.5%* +1.8% +2.7% (3 year trend)

1 Current data are for 2013, unless marked by an asterisk (*).

* Data marked by an asterisk are from 2012. 2 For data that are quantities (e.g., enrollment numbers), change over time is calculated using a percent change. For data that are already percentages (e.g., unemployment rates), change over time is calculated using a net change (subtraction).

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS PROFILE OF PARTICIPANTS


Profile of Participants

Number of Children and Families Served

Since the development of its evaluation system, First 5 Santa Cruz County has had the unique ability

to gather unduplicated counts of individuals served within partner programs and across those

programs. These data—or client characteristic data (hereafter referred to as “CCDs”)—are

submitted by partners and analyzed to determine the unduplicated count of individuals served by

program, by goal area, and overall.

Figure 4: Number of Services to Children and Parents, by Goal Area (2012-2013)

GOAL AREA

CHILDREN (AGES 0‐5)

PARENTS

NUMBER PERCENT NUMBER

(AGES <18)NUMBER

(AGES 18+) TOTAL NUMBER

PERCENT

Healthy Children 3,054 35.8% 0 0 0 0.0%

Strong Families 472 5.5% 8 622 630 91.4%

Children Learning and Ready for School 5,006 58.7% 0 59 59 8.6%

Total Number of Services (includes clients served in multiple goal areas)

8,532 100.0% 8 681 689 100.0%

Unique Number of Clients* (unduplicated number of clients

across all goal areas) 7,966 8 679 687

Source: SUN database/CCD data for July 1, 2012 – June 30, 2013.

* 562 children and 2 parents received services from more than one goal area.

It should be noted that some partners serve both children and their parents, but have collected

CCDs only for the children. These partners include the Health Care Outreach Coalition, Raising A

Reader, Migrant Education (Summer Pre‐K), Side by Side, the Neurodevelopmental Clinic, and early

educators using the Child Snapshot.

Additionally, First 5 funds some programs that collect data on participants, but not CCDs. Therefore,

the number of individuals reached through First 5’s investments is actually greater than what is

reported in the unduplicated count of people served. For instance,

2,530 Kits for New Parents were distributed to individuals at clinics, hospitals, and events

throughout the County;

301 parents participated in Transition to Kindergarten Workshops;

PROFILE OF PARTICIPANTS

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PROFILE OF PARTICIPANTS


1,080 parents participated in Triple P parenting Seminars and Workshops;

123 service providers participated in First 5’s Service Integration Brown Bag Lunches;

28 service providers participated in First 5’s “Achieving Excellence in Customer Service”

trainings.

According to the 2013 population estimates for Santa Cruz County, there were approximately

18,753 children ages 0‐5 residing in the County (including 10,377 Latino children).6

During the 2012‐2013 fiscal year, partners funded by First 5 served 7,966 unique children,

approximately 42% of all children ages 0‐5 in the County.

Among the Latino population, 59% of all children ages 0‐5 participated in services funded by

First 5.

Figure 5: Percentage of Children 0-5 in Santa Cruz County Served by First 5

Source: (Children 0‐5 served by First 5) Client counts are for fiscal years, taken from SUN database/CCD data, July 1, 2006 – June 30, 2013. (County populations of children 0‐5) State of California, Department of Finance, Report P‐3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010‐2060. Sacramento, California, January 2013.

It is important to note that the percentage of children served in the County is actually higher if one

includes children who were indirectly supported by a First 5‐funded program, such as children

whose child care providers received professional training through funded partner programs,

children whose parents received a Kit for New Parents or attended a parent workshop, and children

benefiting from service providers who attended Brown Bag Lunches and customer service trainings.

6 State of California, Department of Finance, Report P‐3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010‐2060. Sacramento, California, January 2013.

31% 30%35%

41%

62%54%

59%

23%27% 26% 27%

44%39%

42%

0%

10%

20%

30%

40%

50%

60%

70%

80%

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12 2012‐13

Percent of County's LatinoChildren 0‐5 Served by First 5

Percent of County's Children0‐5 Served by First 5

Indicator: Percentage of children in in Santa Cruz County served by First 5



Increase Services into Communities with the Highest Needs

As can be seen in the following figure, over the past several years funded partners have consistently

served Latino and Spanish‐speaking children, children who reside in South County, and children

from low‐income backgrounds. Across the years, at least three‐fourths of families served lived

below the Federal Poverty Level.

Figure 6: Demographics of Children Participating in First 5 Programs, by Year

Source: (Latino, Spanish, South County, Income) SUN database/CCD data for July 1, 2007 – June 30, 2013. (Federal Poverty Level for family of five) U.S. Department of Health and Human Services, Poverty Guidelines, 2008‐2013.

N: (2007‐2008) Ethnicity = 4,235; Language = 4,192; Region of County = 5,214. (2008‐2009) Ethnicity = 4,968; Language = 4,896; Region of County = 5,440. (2009‐2010) Ethnicity = 5,620; Language = 5,563; Region of County = 5,276. (2010‐2011) Ethnicity = 8,848; Language = 9,086; Region of County = 8,932. (2011‐2012) Ethnicity = 8,046; Language = 8,235; Region of County = 8,082. (2012‐2013) Ethnicity = 7,757; Language = 7,809; Region of County = 7,577.

In a 2005 assessment of the levels of children’s vulnerability within Santa Cruz County, 10 indicators

of risk were measured and tracked by ZIP code within Santa Cruz County: income relative to the

Federal Poverty Threshold, self‐sufficiency, Medi‐Cal births, parental unemployment, births to

teens, referrals to child welfare services, child abuse, child witnesses to domestic violence, adults

without a high school degree, and linguistic isolation. For each indicator, one of four levels of risk

was assigned.

72.0%

64.3%

79.0%

73.2%

64.9%

82.2%

75.2%

70.6%

85.1%

80.5%

74.9%

86.6%

65.8%

74.4%

83.0%

54.9%

73.7%

81.7%

50% 60% 70% 80% 90% 100%

South County

Spanish as Household Language

Latino

2007‐08

2008‐09

2009‐10

2010‐11

2011‐12

2012‐13

Indicator: Demographic trends in children participating in First 5 programs

Indicator: Levels of children’s vulnerability in Santa Cruz County, by ZIP code



In the following map, the combined risk of these 10 indicators has been determined and displayed

for each ZIP code to illustrate the areas of highest vulnerability for children ages 0‐5 in Santa Cruz

County. In addition to the combined risk for each ZIP code, dots indicate if the ZIP code had a school

that had an Academic Performance Index (API) score of 3 or lower.

This map will be updated as soon as the 2010 U.S. Census data for these indicators of risk are

available by county and ZIP code.

Figure 7: Levels of Children’s Vulnerability in Santa Cruz County, by ZIP code

Source: Applied Survey Research, Geo‐Mapping Children’s Vulnerability in Santa Cruz County, Presentation to First 5 Santa Cruz County, 2005.



In order to determine whether First 5 partners are serving children in the highest need areas of the

County, this second map displays the relative size of client populations, with darker colors indicating

more First 5 participants served than lighter colors. As seen in the following table, 91% of children

(with known ZIP codes) served by funded partners lived in the areas of the County that ranked

highest on a cumulative index of risk factors (the Live Oak area of Santa Cruz, the city of Santa Cruz,

Watsonville and Freedom), showing that First 5 partners are reaching the most vulnerable children.

Figure 8: Distribution of Children Who Received Services, by ZIP Code (2012-2013)

Figure 9: Number of Children Who Received Services, by ZIP Code (2012-2013)

AREA ZIP CODE

NUMBER OF

CHILDREN SERVED

AREA ZIP CODE

NUMBER OF

CHILDREN SERVED

Aptos, Rio Del Mar 95003 116 Mt. Hermon 95041 1

Ben Lomond 95005 43 Santa Cruz* 95060 540

Boulder Creek 95006 59 Santa Cruz (Live Oak) 95062 824

Brookdale 95007 4 Santa Cruz 95064 33

Capitola 95010 73 Santa Cruz 95065 72

Davenport 95017 28 Scotts Valley* 95066 138

Felton 95018 46 Soquel 95073 63

Freedom 95019 275 Watsonville* 95076 5,064

Total ‐ 7,379 Source: SUN database/CCD data for July 1, 2012 – June 30, 2013.

* Children with Post Office mailing addresses in these areas were included in the area totals.

Legend

Frequency



Early Childhood Educators Served by First 5 Partners

First 5 Santa Cruz County helps support the professional development of early childhood educators

in the community.

In 2012‐13, there were 138 early childhood educators from preschools and family child care

homes who received professional development training from the SEEDS of Early Literacy or

Race to the Top programs. These programs collected enough information to create a Unique

ID for each client, thereby allowing these early childhood educators to be enumerated and

tracked across multiple services.

There were additional early childhood educators who participated in funded programs and

received professional development training, but who were not tracked using a Unique ID.

These include:

o Child Signature Program (CSP)

50 early childhood educators who attended the CLASS overview trainings

48 early childhood educators who completed the “Looking at CLASSrooms” (LAC) trainings

50 early childhood educators who attended the “Kids and Smoke Don't Mix” online tobacco trainings

o Side by Side

40 staff/child care providers who received training from Side‐by‐Side Clinician/Consultants

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS HEALTHY CHILDREN


Healthy Children

This portion of First 5 Santa Cruz County’s Strategic

Framework analysis includes data regarding the

current estimates of children without health

insurance, enrollment outcomes from the Healthy Kids

Initiative’s Health Care Outreach Coalition, results from the Newborn Enrollment Project, and health

insurance utilization and re‐enrollment data. Additional information about partners’ efforts to

support Healthy Children can be found in the Partner Profiles section of this report.

Increase Insurance Coverage

The majority of children ages 0‐5 in Santa Cruz County have health insurance (99%), according to the

most recent estimates from the California Health Interview Survey (CHIS; 2011‐12). During this

continuing period of economic instability, it is especially important to continue providing assistance

to families to enroll in public health insurance programs, so that every child ages 0‐5 is insured.

Figure 10: Percentage of Children Ages 0-5 Estimated to be Insured

Source: UCLA Center for Health Policy Research, California Health Interview Survey (CHIS), 2001‐2011/12.

93.7%94.5%

95.9%

96.5%93.9%

96.2%

93.3%

99.1%

80%

85%

90%

95%

100%

2001 2005 2009 2011‐12

California

Santa Cruz County

Indicator: Percentage of children in Santa Cruz County with health insurance coverage

HEALTHY CHILDREN

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT HEALTHY CHILDREN


Public health insurance programs are essential to the overall health and well‐being of children. The

Health Care Outreach Coalition (HCOC) provides assistance with application and enrollment in public

health insurance to income‐eligible families. Through community outreach workers called Certified

Application Assistors (CAAs), children from families earning up to 300% of

the Federal Poverty Level receive assistance in applying for Medi‐Cal,

Healthy Families, and the local Healthy Kids health insurance plan.

Additionally, HCOC staff participate in community events and respond to

business and community agency requests for presentations and additional

information regarding health insurance.

The following figures present the number of children ages 0‐5 newly enrolled

in health insurance, and number of enrollees who renewed their health insurance. Across the years

since the effort began in 2004, 11,410 children ages 0‐5 have been enrolled in public health insurance.7

The large increase in Medi‐Cal enrollments in 2009‐10 is due to the Newborn Enrollment Project

(described subsequently), and the 2012‐13 increase in Medi‐Cal re‐enrollments reflects the efforts that

began in January 2013 to move all children enrolled in the Healthy Families Program into the new

coverage provided by Medi‐Cal known as Targeted Low‐income Children’s Program (“Medi‐Cal TLC” or

“Medi‐Cal for Families”).

Figure 11: Number of Children (Ages 0-5) Newly Enrolled by HCOC in Publicly-Funded Health Insurance Programs

Source: Health Care Outreach Coalition, County Benefits Tracking Report, 2013; Health Care Outreach Coalition, Newborn Enrollment Statistics, 2013.

7 County of Santa Cruz Health Services Agency, 2013.

580519

620

1,312

1,741

2,185

1,871

53 42 67

901

1,226

1,6811,609

352 359395

315

445 429

205175 118 158

96 70 75 57

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

2,200

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12 2012‐13

Total

Medi‐Cal

Healthy Families

Healthy Kids

Indicator: Number of children ages 0‐5 in Santa Cruz County who are enrolled in publicly‐funded health insurance through the Health Care Outreach Coalition



Figure 12: Number of Children (Ages 0-5) Re-Enrolled by HCOC in Publicly-Funded Health Insurance Programs

Source: Health Care Outreach Coalition, County Benefits Tracking Report, 2013; Health Care Outreach Coalition, Newborn Enrollment Statistics, 2013.

Baby Gateway—the Newborn Enrollment Project—operates in three local hospitals in Santa Cruz

County with funding and support provided by First 5: Watsonville Hospital, Dominican Hospital, and

Sutter Maternity & Surgery Center of Santa Cruz. The main goals of the project are to provide

enrollment assistance to mothers and their newborns, as well as to establish a seamless Medi‐Cal

coverage process for Medi‐Cal‐eligible newborns, and to link those newborns to a medical home, all

before they leave the hospital.

In addition, all new mothers receive the First 5 “Kit for New Parents” containing expert guidance for

raising healthy infants and children. In particular, parents are oriented to the “What To Do If My Child

Gets Sick” booklet, which provides information in utilizing primary care appropriately, and clarifies what

issues should prompt a visit to the emergency room, and which should be handled in the medical home.

Newborn Enrollment Results

Data from 2012‐13 show how successful this program has been in providing these services to Santa

Cruz County’s mothers and newborns.

Of all 3,155 births that occurred in Santa Cruz County at these hospitals in 2012‐13, 73% of

mothers received a newborn visit while in the hospital, and 56% received a “Kit for New Parents.”

Of all 1,748 mothers with Medi‐Cal births during 2012‐13, 83% were assisted to complete a

Medi‐Cal application for their new babies.

Of the 1,453 mothers who were assisted to complete a Medi‐Cal application for their

newborns, nearly all applications (99.8%) were approved, and 94% were assigned a primary

care provider for their child before discharge from the hospital.

27 19 40 139

269

455

682

257

318

411 487442 440

296181 182

131 150 12097 92

0

100

200

300

400

500

600

700

800

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12 2012‐13

Medi‐Cal

Healthy Families

Healthy Kids

Indicator: Number of mothers in Santa Cruz County visited as part of the Newborn Enrollment Project



Figure 13: Newborn Enrollment Project Statistics (2012-2013)

PROGRAM COMPONENT WATSONVILLE

COMMUNITY

HOSPITAL

DOMINICAN

HOSPITAL SUTTER

MATERNITY &

SURGERY CENTER OF SANTA CRUZ

TOTAL

Total Number of All Births in Santa Cruz County

1,344 869 942 3,155

Total Number of Medi‐Cal Births 1,144 358 246 1,748

NUMBER PERCENT OF ALL MEDI‐CAL BIRTHS

Number of Completed Newborn Medi‐Cal Applications

982 328 143 1,453 83.1%

NUMBER PERCENT OF ALL MEDI‐CAL

APPLICATIONS

Number of Approved Newborn Medi‐Cal Enrollments 981 326 143 1,450 99.8%

Number of Denied Newborn Medi‐Cal Applications 1 2 0 3 0.2%

Number of Pending Newborn Medi‐Cal Applications 0 0 0 0 0.0%

Number of Newborn Medi‐Cal Applicants with an Assigned Primary Care Provider

1,364 93.9%

NUMBER PERCENT OF ALL COUNTY BIRTHS

Total Number of Newborn Visits (regardless of insurance status)

1,203 712 388 2,303 73.0%

Number of Kits for New Parents Distributed

841 605 329 1,775 56.3%

Source: Health Care Outreach Coalition, Newborn Enrollment Statistics, 2013.



Increase Use of Medical/Dental Homes

The majority of County children enrolled in Healthy Kids, ages 2‐6, had access to a primary care

practitioner. In 2012, 97% of children had a medical home, which is slightly higher than it has been

for the past several years.

Figure 14: Percentage of Children in the County Enrolled in Healthy Kids (Ages 2-6) Who Had Access to a Primary Care Practitioner

Source: Central Coast Alliance for Health, Health Care Quality Measurement annual report, using HEDIS Indicators.

N: (2006)=227, (2007)=221, (2008)=227, (2009)=208, (2010)=164, (2011)=134, (2012)=107.

Parents of children receiving enrollment services through the Health Care Outreach Coalition were

asked when they renewed their children’s insurance whether their children had used the benefit

during the previous year. During the 2012‐2013 year, nearly all children (99%) who received renewal

assistance in a public insurance program utilized their benefits prior to their renewal, continuing the

trend of high utilization across the years.

Figure 15: Percentage of County Parents Reporting their Children Utilized Health Care Prior to Renewal in an Insurance Program

Source: Health Care Outreach Coalition, Annual Progress Report, 2007‐2013. Results represent the status of children’s applications 2‐3 months after the end of the fiscal year.

N: (2006‐07)=471, (2007‐08)=514, (2008‐09)=555, (2009‐10)=789, (2010‐11)=829, (2011‐12)=1,013, (2012‐13)=1,102.

89.9% 90.1%93.8%

89.4%95.1% 94.0%

97.2%

50%

60%

70%

80%

90%

100%

2006 2007 2008 2009 2010 2011 2012

99.6% 97.9% 99.6% 99.4%96.6%

99.6% 99.0%

50%

60%

70%

80%

90%

100%

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12 2012‐13

Indicator: Percentage of children in Santa Cruz County enrolled in Healthy Kids (ages 2‐6) who had access to a primary care practitioner

Indicator: Percentage of children in Santa Cruz County utilizing health care prior to renewal in an insurance program



Dental care is a critical component of overall health, and children who get regular dental check‐ups

are less likely to suffer from tooth and gum disease. Many children ages 0‐5 in Santa Cruz County are

covered by dental insurance and are getting annual dental check‐ups.

In 2011, 84% of families surveyed as part of the Community Assessment Project said that at

least one of their children ages 0‐5 had dental insurance.

In 2011‐12, CHIS data reported that 83% of children ages 0‐5 had a dental visit in the past year.

Figure 16: Percentage of County Children Receiving Dental Care (Ages 0-5)

County Children (0‐5) With Dental Insurance (2011) “How many of your children have insurance?”

Source: Applied Survey Research, Santa Cruz County Community Assessment Project (CAP), 2012. N=107.

County Children (0‐5) With a Dental Visit in the Past Year

Source: UCLA Center for Health Policy Research, California Health Interview Survey (CHIS), 2013.

There are still some children who are not receiving dental care, and the costs are high. Data from

2005‐2007 show that throughout California, thousands of children ages 0‐5 are going to the

emergency department with preventable dental conditions. In 2003 the Santa Cruz County Health

Services Agency reported that “77% of Santa Cruz County students had untreated dental cavities,

and over 20% had abscessed teeth.”8 The authors of this Health Bulletin warned:

“School children who suffer the pain of decay have less learning and concentration ability.

Nationwide, children with oral health problems miss almost 52 million school hours annually.”

Figure 17: Rate of California Children Visiting the ED for Preventable Dental Conditions (per 100,000, Ages 0-5)

Source: California HealthCare Foundation, Snapshot: Emergency Department Visits for Preventable Dental Conditions in California, 2009.

8 County of Santa Cruz, Health Services Agency, Health Bulletin: Local Public Health Officials Support Fluoridation, by Khalsa, R., & McNutt, D. (2003).

15.9%

84.1%

0%

20%

40%

60%

80%

100%

No child (0‐5) hasinsurance

At least one child (0‐5)has insurance

75.2% 82.5%

0%

20%

40%

60%

80%

100%

2009 2011‐12

189 222 203

0

100

200

300

2005 2006 2007

Indicator: Percentage of children in Santa Cruz County who are getting dental care



Increase Use of Preventive Health Services

In 2012, the majority of children ages 3‐6 enrolled in Healthy Kids (85%) received a well‐child visit

with their pediatrician, showing an increasing trend over the past five years.

Figure 18: Percentage of Children (Ages 3-6) in the County Enrolled in Healthy Kids Who Received a Well-Child Visit

Source: Central Coast Alliance for Health, Health Care Quality Measurement annual report, using HEDIS Indicators.

N: (2006)=210, (2007)=207, (2008)=211, (2009)‐191, (2010)=152, (2011)=117, (2012)=97.

Ideally, children and their families who have insurance and who have a medical home will be more

likely to access their provider for routine preventive care, and less likely to use the emergency

department (ED) for non‐urgent medical care.

Survey data show that in 2011‐12, 16% of children ages 0‐5 in Santa Cruz County visited the

ED in the past year, which is lower than the peak of 32% in 2007.

Figure 19: Percentage of Children (Ages 0-5) in the County Who Visited the Emergency Department in the Past Year

Source: UCLA Center for Health Policy Research, California Health Interview Survey (CHIS), 2013.

78.1% 81.6%76.8% 79.6%

82.9%87.2% 84.5%

50%

60%

70%

80%

90%

100%

2006 2007 2008 2009 2010 2011 2012

16.1%

31.7%

25.6%

15.7%

0%

10%

20%

30%

40%

50%

2005 2007 2009 2011‐12

Indicator: Percentage of children in Santa Cruz County enrolled in Healthy Kids (ages 3‐6) who received a well‐child visit



The services provided by the Newborn Enrollment Project may also have had an effect on the use of

the Emergency Department (ED) for children less than one year old.

ED visits typically peak during the first two quarters of each year. Consequently, when comparing ED

visits at a hospital before and after the launch of Baby Gateway, it was important to evaluate the

same quarter when making comparisons between years. In the following analysis, results for

Quarter 1 were compared.

Baby Gateway was launched at Watsonville Community Hospital in August 2009. When

comparing the data for Quarter 1 of 2009 and 2013, the number of ED visits for infants under

one year dropped from 573 to 367 (a 36% decrease).

Similarly, after Baby Gateway was launched at Dominican Hospital in January 2011, ED visits

for infants under one year dropped from 186 to 176 (a 5% decrease).

Figure 20: Number of Emergency Department Visits (Infants Less Than One Year Old)

Source: Health Improvement Partnership of Santa Cruz County, Healthy Kids Biannual Evaluation, July 2012 – June 2013.

573

632

552 558

506528

471

421 424446

349381 395

342

428401

367

218184

151171

199

146116

168186

148116

137163

112128 118

176

0

100

200

300

400

500

600

700

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1

WatsonvilleCommunityHospital

DominicanHospital

Baby Gateway Launched at

Dominican and Sutter Hospitals


Watsonville Community

Hospital

2009 2010 2011 2012 2013



Increase Number of Children Reaching Developmental Milestones

In 2012‐13, approximately 7% of kindergarten students in Santa Cruz County received special

education services, demonstrating the importance of having services available to address the

developmental issues of these very young children.

Figure 21: Percentage of County Children in Kindergarten Enrolled in Special Education

Source: California Department of Education, Special Education Division.

N: (2006‐07)=2,909; (2007‐08)=2,921;( 2008‐09)=3,031, (2009‐10)=3,267, (2010‐11)=3,149, (2011‐12)=3,327, (2012‐13)=3,219.

The Dominican Interdisciplinary Child Development Program (DICDP) is an innovative, coordinated

approach to address the neurodevelopmental needs of very vulnerable children ages 0‐5 in the

foster care system. In October 2011, the DICDP and its interdisciplinary team began providing

comprehensive services to these children ages 0‐5, in order to assess, intervene, and treat their

developmental and social/emotional issues as early as possible. The DICDP also established a plan to

build the capacity of community partners to support the services that are recommended for these

children, in order to streamline this referral process.

The DICDP collects key data regarding the population they serve, and the following charts provide a

profile of the child population that received services from the DICDP between 2011‐13, and the

types of referrals that were made after assessments.

Figure 22: Demographics of the Children (Ages 0-5) Participating in the DICDP (2011-2013)

Race/Ethnicity Age

Source: Dominican Interdisciplinary Child Development Program, Data Template, 2011‐2013.

N: (Gender, Race/Ethnicity, Age)=146; (Language)=145.

6.6% 6.3%5.5% 6.0% 6.0% 7.1% 7.2%

0%

2%

4%

6%

8%

10%

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12 2012‐13

Latino / Hispanic, 54.1%

Caucasian / White, 40.4%

Other, 5.5% 12.3%

27.4%

13.7%13.7%

15.8%

17.1%< 1 year old

1 year old

2 years old

3 years old

4 years old

5 years old

Indicator: A coordinated approach to address the neurodevelopmental needs of very vulnerable children ages 0‐5 in the foster care system



Figure 23: Percentage of Children in DICDP (Ages 0-5) With These Diagnoses and Services, at Intake (2011-2013)


* Children’s developmental levels were assessed using one of two standardized assessments, depending on the age of the child: the Bayley Scales of Infant and Toddler Development or the Wechsler Preschool and Primary Scales of Intelligence, 3rd edition.

** The number of children receiving Physical Therapy at intake was not measured in 2012‐13

N: (IEP, ADHD, Occupational Therapy, Developmental Disability Services)=146; (Delayed, Severely Delayed)=141; (Autism)=95; (Physical Therapy)=51.

Figure 24: Percentage of Children in DICDP (Ages 0-5) Provided With These Referrals (2011-2013)


* San Andreas Regional Center (SARC)

** The number of children referred to Occupational Therapy was not measured in 2011‐12.

N: (All referrals except OT) =146; (Occupational Therapy)=95.

12.8%

1.4%4.8% 2.1% 2.0%

17.7%

4.3% 4.8% 3.2% 2.7%

30.5%

5.7% 4.8% 4.8%3.2% 2.7% 2.1% 2.0%

0%

5%

10%

15%

20%

25%

30%

35%

"Delayed"Developmental

Level*

"SeverelyDelayed"

DevelopmentalLevel*

Diagnosed withADHD

ReceivingOccupational

Therapy

Diagnosed withAutism

Has an IEP ReceivingDevelopmental

DisabilityServices

ReceivingPhysical

Therapy**

TOTAL 0‐5

Ages 3‐5

Ages 0‐2

0.7%2.7%

0.7% 2.1% 2.1% 0.7%

15.1%

2.1%

2.1%1.1% 1.1%

0.7%0.7%

15.8%

4.8%

2.8% 3.2% 3.2%1.4% 0.7%

0%

5%

10%

15%

20%

School district(IEP/IFSP

development)

Triple P(Parenting skills)

Audiology SARC*/Early Start(Developmentaldisability services)

OccupationalTherapy**

Ophthalmology Genetics

TOTAL 0‐5

Ages 3‐5

Ages 0‐2

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS STRONG FAMILIES


Strong Families



Commission’s goals to decrease child abuse and neglect

and improve parent and caregiver practices that support

children’s social/emotional development. Additional information about partners’ efforts to support

Strong Families can be found in the Partner Profiles section of this report.

Decrease Child Abuse and Neglect

The rate of substantiated allegations of child maltreatment in Santa Cruz County has decreased from

a high of 16.2 (per 1,000) in 2004, to 8.0 (per 1,000) in 2012. In 2012, the County rate dropped lower

than the state‐wide rate of substantiated allegations of child maltreatment for the second time

since 2004. The decreasing rates in Santa Cruz County may have been assisted by the efforts of the

Families Together program, which launched in late 2006.

Figure 25: Rate of Substantiated Allegations of Child Maltreatment in Santa Cruz County and California (per 1,000)

Source: Needell, B., Webster, D., Armijo, M., Lee, S., Dawson, W., Magruder, J., Exel, M., Cuccaro‐Alamin, S., Putnam‐Hornstein, E., Williams, D., Simon, V., Hamilton, D., Lou, C., Peng, C., Moore, M., King, B., Henry, C., & Nuttbrock, A. (2013). Child Welfare Services Reports for California. Retrieved 10/2/13, from University of California at Berkeley Center for Social Services Research website. <http://cssr.berkeley.edu/ucb_childwelfare>

16.215.7

13.714.5

12.2

10.2

8.8

11.0

8.0

11.6 11.5 11.3 11.210.2 10.0

9.6

9.5

9.3

0

2

4

6

8

10

12

14

16

18

2004 2005 2006 2007 2008 2009 2010 2011 2012

Santa Cruz County

California

Indicator: Rate of substantiated allegations of child maltreatment in Santa Cruz County

Strong Families

STRONG FAMILIES

Families Together

Launched 9/2006

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRONG FAMILIES


Families Together is Santa Cruz County’s differential response program, a strategy used to intervene

early with families in which there has been an allegation of child abuse or neglect. This home visiting

program includes comprehensive intake and risk assessment, development of a tailored case plan,

parent support and education, child development activities, and follow‐up risk assessments.

The following figure presents the percentage of families at each level of risk over three assessments

(baseline, first reassessment, and second reassessment). Only families with an initial risk level of

“moderate” or higher are included in this analysis. Since each year’s analysis is constrained by fairly

small sample sizes, several years of data have been aggregated in order to present a more robust

portrait of the extent to which Families Together participants are reducing their risk for future

involvement with the child welfare system. As can be seen, 61% of families were assessed as being

“high risk” or “very high risk” upon intake, and this dropped to 12% by the second reassessment,

indicating that the program is helping families reduce their level of risk.

Figure 26: Change in Families Together Participants’ Risk Levels Over Time (2007/08 - 2012/13)

Source: SUN database, Structured Decision Making: Family Prevention Services Screening Tool (SDM:FPSST) data, 2008‐2013.

Of the 78 families who received services from Families Together and had their cases closed in the

2012 calendar year:

95% did not have a substantiated allegation of maltreatment within six months after case

closure. This figure is comparable to what was observed in the previous years.

An additional study found that 17% had been re‐referred to child welfare within six months

after their exit from Families Together.

30.4%36.0%

39.1%

49.7% 51.8%46.1%

17.9%

8.6%14.7%

2.0% 3.6%

0%

10%

20%

30%

40%

50%

60%

70%

Baseline* (N=373) 1st Reassessment (N=296) 2nd Reassessment (N=139)

Low Risk

Moderate Risk

High Risk

Very High Risk

Indicator: Percentage of Families Together participants at each level of risk, baseline to reassessment

Indicator: Percentage of Families Together participants with substantiated allegations of child maltreatment within 6 months of program completion



These results indicate that although some families are re‐referred to child welfare after exiting from

Families Together, the rate of substantiated abuse is low. This suggests that even though families

are still experiencing high risk factors that lead to a child welfare report, they may have gained skills

and resources during their participation in Families Together that prevent court‐mandated

involvement with child welfare. A further study of the factors related to these re‐referrals that are

not substantiated could support the program and the child welfare system to best serve the

families.

Improve Parent and Caregiver Practices that Support Children’s Social and Emotional Development

The Triple P Program

First 5 Santa Cruz County has led the implementation of the Triple P – Positive Parenting Program

since late 2009, in partnership with two local funders (Health Services Agency and Human Services

Department) and agencies that serve children and families. Triple P is a comprehensive, evidence‐

based parenting and family support system designed to increase parents’ confidence and

competence in raising children, improve the quality of parent‐child relationships, and make

evidence‐based parenting information and interventions widely accessible to parents. First 5 is now

implementing the full suite of Triple P services, which is designed to reach an entire community as

well as individual families through:

A media‐based social marketing campaign;

Seminars on general parenting topics;

Workshops on specific parenting topics;

Brief consultations regarding a specific parenting concern;

In‐depth parent education and skills training; and

Additional support to help parents deal with other stressors that impact their parenting

Selected data for key indicators are highlighted below for their significance, and more detailed data are

presented in the Triple P Partner Profile found later in this report.

In the first few years of start‐up and implementation, First 5 was successful at raising awareness

about the Triple P program in health and social service organizations that serve children and families.

While these organizations have played a critical role in the initial success of Triple P by referring

Indicator: Level of community members’ engagement in Triple P social marketing and outreach activities



clients and hosting classes, it has always been First 5’s goal to achieve the population‐based

(community‐wide) implementation that was proven effective in the Centers for Disease Control’s

research study.9 In 2012‐13, First 5 contracted with Miller Maxfield, a local communications firm, to

expand its local Triple P social marketing campaign in order to reach a broader population of parents,

including those who are less likely to seek support from a social service agency. The goals of this

year’s campaign were to:

Define key messages that highlight the benefits of Triple P and normalize the need for

parenting support;

Create local Triple P branding (name, look, messaging) to be reflected in all campaign

activities and materials;

Promote the Triple P ‐ Positive Parenting Program throughout Santa Cruz County;

Engage families, parents and local agencies in the Triple P Positive Parenting Program.

This year’s campaign activities have resulted in a more cohesive and comprehensive approach to

increasing awareness about the benefits and availability of the Triple P program in Santa Cruz

County. Three of the most effective campaign strategies this year were:

1. Developing and disseminating nearly 20,000 copies of the Triple P Parenting Pocket

Guide to parents, schools, and organizations that interact regularly with families. This

colorful, bilingual guide is the size of a business card when folded up, yet contains several

practical parenting tips as well as information about how to find Triple P classes and

practitioners.

2. Developing a 12‐month content calendar that guided the content of monthly articles,

e‐newsletters, and Facebook posts. This planned approach to developing engaging

content contributed to a 1,698% increase in Facebook fans between July 2012 (40 fans)

and June 2013 (719 fans). These efforts were also a contributing factor to the increase in

parents who signed up to receive the monthly e‐newsletters.

3. Actively engaging the media to promote Triple P services. Miller Maxfield distributed

media alerts highlighting the schedule of Triple P classes every month and distributed

press releases to generate coverage of special activities or featured classes. These efforts

resulted in earned media coverage 103 times throughout the year.

9 Prinz, R. J. , Sanders, M. R., Shapiro, C. J., Whitaker, D. J. & Lutzker, J. R. (2009). Population‐Based Prevention of Child Maltreatment: The U.S. Triple P System Population Trial, Published online @ Springer Link <link.springer.com>.



A new analysis of Triple P outcomes indicates that parents who began the program with more

serious parenting issues demonstrated the greatest improvements as a result of receiving in‐depth

services (8 or more sessions). The majority of All Parents who received in‐depth Triple P services

demonstrated improvement in each of these five parenting domains: Perception of child’s behavior;

Overall parenting style; Depression; Anxiety; Stress. While this is noteworthy, parents who entered

the program experiencing higher levels of distress related to parenting, as indicated by pre‐

assessment scores in a “Clinical Range of Concern,” showed an even greater degree of improvement

in all domains at post‐assessment. This is particularly true for parents of adolescents. These results

suggest that Triple P was particularly effective for parents who entered the program with more

serious parenting issues.

Figure 27: Percentage of Parents Who Demonstrated Improvement in One or More Key Parenting Domain (2010-2013)

Source: Triple P assessment results (analyzed by Applied Survey Research), 2013. (Child behavior) Eyberg Child Behavior Inventory, Problem subscale: Number of child behaviors perceived to be a problem; (Style) Parenting Scale, Overall score ; (Depression) Depression, Anxiety, and Stress Scale – Short Version (DASS‐21),Depression subscale; (Anxiety) DASS‐21, Anxiety subscale; (Stress) DASS‐21, Stress subscale.

N: (Child behavior) All=417, Clinical=200; (Style) All=490, Clinical=110; (Depression) All=526, Clinical=139; (Anxiety) All=526, Clinical=179; (Stress) All=525, Clinical=135.

Parents who participated in Levels 4 and 5 of the Triple P program were asked to complete the

Parenting Scale as a self‐assessment of their parenting style (this was only completed if the parent

had at least one child aged 18 months or older). Scores could range from 1 (positive parenting) to 7

(ineffective parenting), with lower scores indicating more positive styles of discipline. An analysis of

pre and post assessment scores indicates that:

There was significant improvement from pre to post assessment, indicating their parenting

style became less lax, less over‐reactive, and less hostile through the course of the Triple P

program.

64.0%76.4%

54.1% 51.5%60.9%

88.0% 81.8% 84.2% 84.9% 89.6%

0%

20%

40%

60%

80%

100%

Perception of child'sbehavior

Overall parentingstyle

Depression Anxiety Stress

All Parents Clinical Range at Pre‐test

Indicator: Percentage of parents experiencing high levels of distress who demonstrate improvement in one or more key parenting domains

Indicator: Use of positive parenting styles



On average, All Parents and all analyzed parent sub‐populations experienced a moderate to

large magnitude of change. These results indicate that these observed differences were not

only statistically significant but also meaningful.

Figure 28: Parents’ Use of Positive Parenting Styles (2010-2013)

Overall

Source: Triple P data from the Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

In Triple P, the parent is considered the agent of change to bring about improvements in the parent‐

child relationship. Therefore, how parents view their children’s behavior is an important assessment

of the relationship.

Parents participating in Levels 4 and 5 of the Triple P Program were asked to complete the Eyberg

Child Behavior Inventory (ECBI), a pre and post assessment of parents’ perception of their children’s

behaviors (this was only completed if the parent had at least one child aged 18 months or older).

Scores ranged from 0 (No) to 36 (Yes), with higher scores indicating greater likelihood that these

behaviors were a problem to the parent. An analysis of pre and post assessments indicate that

parents reported fewer problematic child behaviors after completing the Triple P program.

Key results include:

On average, for All Parents and all parent sub‐populations, there was a significant reduction

in the number of child behaviors that were perceived to be a problem. Of special note,

certain sub‐populations of parents scored above the clinical cut‐off at the beginning of the

program, and subsequently ended out of a range of concern by the end of the program.

These sub‐populations included parents with scores in the Clinical Range at Pre‐test, Female,

Latino, and Spanish‐speaking parents.

3.23.2

3.2 3.43.0

3.5

3.13.1

2.6 2.7 2.6 2.82.4

2.92.5 2.7

1

2

3

4

5

6

7

All Parents**(N=490)

Male**(N=142)

Female**(N=348)

Latino**(N=273)

Caucasian**(N=171)

Spanish**(N=178)

English**(N=295)

Child WelfareInvolved*(N=132)

Pre Post

Indicator: Report of child behavior problems

Dysfunctional Parenting

Functional Parenting

Lower is

“Better”



An analysis of Effect Size on all the improvements made showed that on average, All Parents

and most parent sub‐populations10 experienced moderate or large magnitudes of change,

indicating that the observed differences were not only statistically significant but also

meaningful.

Figure 29: Parents’ Perceptions of Child Behavior (2010-2013)

Number of Child Behaviors Perceived to Be a Problem

Source: Triple P data from the Eyberg Child Behavior Inventory, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013.

* Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05.

** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

10 On both subscales of the ECBI, only parents who were Child Welfare Involved did not show a moderate to large effect size.

14.5

22.7

11.5

15.7 15.712.8

16.612.9 9.5

7.911.9

6.68.4 8.4

7.79.3

6.9 6.60

6

12

18

24

30

36


ClinicalRange atPreTest**(N=200)

Male**(N=117)

Female**(N=300)

Latino**(N=242)

Caucasian**(N=132)

Spanish**(N=164)

English**(N=239)

ChildWelfareInvolved*(N=111)

Pre PostAll behaviors were

a problem

No behaviors were a problem

Clinical Cut‐off: >=15

Lower is

“Better”

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS CHILDREN LEARNING AND READY FOR SCHOOL





Commission’s goals of increasing the quality of early

learning programs and improving children’s early

literacy skills. Additional information about partners’

efforts to support Children Learning and Ready for School can be found in the Partner Profiles section of

this report.

Increase the Quality of Early Learning Programs


collaboration with local partners, with the goal of improving the quality of early learning programs

in Santa Cruz County. First 5 established this initiative as a result of receiving funding through

California’s Race to the Top ‐ Early Learning Challenge (RTT‐ELC) federal grant, and First 5

California’s Child Signature Program (CSP). While both of these grants share a common goal of

increasing the quality of early learning programs and closing the achievement gap for vulnerable

young children, implementation requirements vary slightly by funder, as described below.

RACE TO THE TOP – EARLY LEARNING CHALLENGE GRANT CHILD SIGNATURE PROGRAM

Funder California Department of Education First 5 California

Grant Goals Build a Quality Rating and Improvement System (QRIS) that results in:

A shared definition of child care quality based on reliable and validated research

A comprehensive and consistent approach to assess quality

A design to evaluate the rating system and its impact

Access to a system that supports quality improvement, especially for programs serving children with high needs (low income children, infants, dual language learners, children with special needs)

A consistent way for providers to communicate to parents and caregivers about quality, and increased consumer awareness about—and demand for—high quality child care

Increase quality in early learning programs for children ages 0‐5 in early care and education (ECE) centers where the educational divide is greatest (i.e., neighborhoods in catchment areas of elementary schools with Academic Performance Index scores in deciles 1‐3).

CHILDREN LEARNING AND READY FOR SCHOOL

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL


RACE TO THE TOP – EARLY LEARNING CHALLENGE GRANT CHILD SIGNATURE PROGRAM

Number of Sites/Classrooms

43 sites at:

Campus Kids Connection

Community Bridges

Encompass Community Services ‐ Head Start & State Preschools

Live Oak School District

Pajaro Valley Unified School District

UCSC

Walnut Avenue Women’s Center

YWCA of Watsonville

19 classrooms at:

Community Bridges

Encompass Community Services – Head Start & State Preschools

Live Oak School District

Pajaro Valley Unified School District

Quality Improvement Process

Conduct baseline and follow‐up ratings using the Hybrid Quality Continuum Framework and Tiers (see Appendix B)

Develop site‐specific Quality Improvement Plans (QIPs)

Develop a county‐wide Quality Improvement Plan

Provide training, technical assistance, and coaching to achieve quality improvement goals in QIPs

Provide incentives to participate in quality improvement efforts

Convene Professional Learning Communities to promote ongoing peer learning

Conduct Readiness Assessments with participating classrooms

Develop classroom‐specific Quality Improvement Plans (QIPs)

Develop county‐wide Quality Improvement Plan

Provide or arrange for training and technical assistance to assist classrooms with achieving goals in QIPs

First 5 established the Santa Cruz County Quality Early Learning Initiative (QELI) Consortium,

bringing together organizations, stakeholders, and 22 early learning professionals who shared a

commitment to improving the quality of early learning and creating a county‐wide Quality

Improvement Plan (QIP). Together, members of the QELI Consortium have been working to achieve

coherence and alignment in developing and piloting a local Quality Rating and Improvement System

(QRIS) as a way to foster ongoing improvement of early care and education programs in Santa Cruz

County.

The QELI Consortium adopted the Hybrid Quality Continuum Framework and Tiers as the foundation

of their local QRIS (see Appendix B). This framework identifies five tiers of quality, with points

assigned to each tier for elements of quality, such as teacher‐child ratios, teacher qualifications, and

teacher‐child interactions. Sites receive a cumulative score based on their ratings, that will

eventually become publicly available to families seeking child care and early learning programs. It is

important to note that the QRIS isn’t just a rating system; it is also an improvement system.

Indicator: A consortium of local partners implementing a county‐wide plan to improve the quality of early learning programs, particularly those serving the most vulnerable children



Participating child care sites receive support, training, and financial incentives to make

improvements that lead to higher ratings and ultimately to higher quality child care programs.

First 5 contracted with Encompass Community Services (formerly known as Santa Cruz Community

Counseling Center) to lead the QELI Consortium’s quality improvement activities, due to the

organization’s extensive experience operating quality Head Start programs. During this past year,

the Early Learning System Specialist (ELSS) employed by Encompass completed Readiness

Assessments with all CSP classrooms, coordinated trainings related to CSP and RTT‐ELC, provided

technical assistance to program directors, developed processes for maintaining centralized records,

and began conducting the QRIS baseline ratings. The following table presents the number of early

childhood educators who participated in any of the QELI trainings provided in 2012‐13.

JULY 1, 2012 – JUNE 30, 2013

Number of early childhood educators in RTT‐ELC sites who received stipends to participate in “The Teaching Pyramid” trainings and coaching

84

Number of early childhood educators in CSP classrooms who attended the “CLASS Overview,” “Looking at CLASSrooms” (LAC), or “Kids and Smoke Don’t Mix” trainings

50*

* Many early childhood educators in CSP classrooms attended more than one of these trainings.

Santa Cruz County has joined with Santa Clara, San Francisco, Alameda, and Contra Costa counties

to form the Bay Area Quality Rating Improvement System Partnership (BAQRISP). This regional

consortium was developed so these neighboring counties could strategize together, share

resources, leverage funds, and align practices. It is anticipated that this regional approach will result

in strengthening the current resources available for professional development and coaching.

The counties in this consortium will also develop and share a common data system called the Bay

Area Regional RTT Database, which will be designed to gather scoring information, track supports

and incentives, ensure participation by targeted programs serving children with High Needs, and

review progress in relation to the Consortium’s local quality improvement targets.

The Starlight Children’s Center (SCC) is a new program for families of children 0‐3 years old. Much

like the original Starlight Infant/Toddler Program (SITP), SCC offers a wide variety of comprehensive

bilingual services for expectant parents and families with infants and toddlers. It is located in the

Indicator: Local QELI resources are leveraged through participation in regional partnerships

Indicator: Model infant/toddler quality site serves as a “learning community” that promotes early literacy and social/emotional skills critical for school success



Starlight Elementary School catchment area of Watsonville, an area with one of the highest

populations of children under the age of five living in poverty in the County. A key goal is to create a

“learning community” that promotes early literacy and social/emotional skills to help lay a solid

foundation for school readiness.

The program provides center‐based services for 10 children, through collaborative funding with the

Early Head Start Program, and operates four days per week for six hours per day. In addition, the

program provides 20 families with home‐based services which include weekly home visits and two

socializations per month. Both center‐ and home‐based services follow the criteria for the federally

funded Early Head Start program, and SCC families receive priority enrollment into Head Start pre‐

school classes once the child turns three years old.

Population Served

2012‐2013

Parents/Guardians 59

Children (Total) 37

(Center‐based) 10(Home‐visited) 37


At the Starlight Children’s Center, center staff and home visitors work with parents of infants and

toddlers to build the foundations for literacy. To guide their efforts with children and their families,

they assess children’s health and development using the Ages and Stages Questionnaire (ASQ) and

ASQ: Social/Emotional (ASQ:SE) screening tool, the DRDP – Infant/Toddler (2010) for children

receiving center‐based services, and the New Portage Guide for children receiving home‐based

services.

Key Results

100% of enrolled children were screened in developmental and social‐emotional areas using

the ASQ/ASQ:SE. Of those children, 21% fell below appropriate developmental thresholds

and received individual support and follow‐up, including rescreening and/or referrals to

community agencies.

Assessment results from the DRDP‐I/T show that toddlers in the Starlight Children’s Center

are being supported to develop social and interpersonal skills, and to develop a strong

foundation for later literacy.



“Reading proficiently by

the end of third grade …

can be a make‐or‐break

benchmark in a child’s

educational development.”

‐ Annie E. Casey

Foundation

Improve Early Literacy Skills of Children

A report released by The Annie E. Casey Foundation found that students who aren’t

reading proficiently by 3rd grade are four times less likely to graduate from high

school, compared to proficient readers.

“Up until the end of third grade, most children are learning to read. Beginning

in fourth grade, however, they are reading to learn, using their skills to gain

more information in subjects such as math and science, to solve problems, to

think critically about what they are learning, and to act upon and share the

knowledge in the world around them. Up to half of the printed fourth‐grade

curriculum is incomprehensible to students who read below that grade level.” 11

In 2013, 36% of third‐graders in Santa Cruz County scored at or above grade level in English/Language

Arts (ELA), compared to 46% of students statewide. After a slight increase between 2008 and 2009 in the

percentage of County 3rd grade students at this level of proficiency, the percentage has stayed relatively

level since 2007. One area of the county with historically low performance has shown notable

improvements in scores, with Pajaro Valley Unified School District (PVUSD) increasing from 21% in 2007

to 24% in 2013, and Freedom Elementary (a school within the PVUSD) demonstrating particularly

remarkable improvement by increasing from 12% to 28%.

Figure 30: Percentage of 3rd Grade Students in the County At / Above Grade Level In English/Language Arts

Source: California Department of Education, STAR Test Results, 2007‐2013.

11 Annie E. Casey Foundation, 2010 KIDS COUNT Special Report: Why Reading by the End of Third Grade Matters, 2010.

37% 38%

44% 44% 46% 48% 46%

34% 34%

40%37%

40% 39%36%

21% 20%25% 24%

28%25%

24%

12% 12%16%

24%28%

24%

28%

0%

10%

20%

30%

40%

50%

60%

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12 2012‐13

California

Santa Cruz County

PVUSD

Freedom Elementary

Indicator: Percentage of 3rd grade students in the County at/above grade level in English/Language Arts



Early Literacy Foundations Initiative

The results of English/Language Arts assessments indicate that California and Santa Cruz 3rd graders

are struggling to become proficient readers, with well over half of 3rd grade children not reading at

proficiency. Because language development in the early years is crucial to later reading success,

early childhood educators have a unique role in influencing reading scores and later educational

success. With the evidence of limited language and literacy opportunities in low‐income homes,

more emphasis has been placed on showing early childhood educators how to build language

opportunities into their daily child care routines, through fun and meaningful instruction.

In 2012‐13, First 5’s Early Literacy Foundations Initiative addressed this need to provide strong literacy

and language foundations for young children through several approaches:

Implemented the SEEDS of Early Literacy model of skill development and coaching for Family

Child Care Providers working with Spanish speaking children.

Expanded the SEEDS Plus program, designed to support early childhood educators working

with children who needed tailored literacy support.

Developed and implemented the new Santa Cruz Reading Corps. In this program,

AmeriCorps volunteers are trained in the SEEDS of Early Literacy curriculum, and work with

the classroom teaching staff to enhance daily literacy opportunities, and conduct literacy

assessments to provide individualized support to help children, with the goal of developing

children’s early literacy skills in English in preparation for kindergarten.

Encouraged family engagement in literacy activities through continuation of the Raising A

Reader program.

Supported child assessments for participating state Pre‐K classrooms in order to tailor

individualized instruction.

Provided other literacy supports for teachers and families.

The following indicators present an overview of the Early Literacy Foundation Initiative’s efforts and

outcomes this year (additional detail is included in the ELF Initiative’s Partner Profile later in this report).

SEEDS of Early Literacy

The professional development initiative mentioned above follows the SEEDS of Early Literacy curriculum

that has been researched by the University of Minnesota. Research on the SEEDS model shows that

teachers trained and coached on the SEEDS of Early Literacy Curriculum score significantly higher on

the Early Language and Literacy Classroom Observation (ELLCO) tool and show greater change over

time in teaching strategies than teachers without such training. Results also indicate that preschool

children who were taught by teachers trained in SEEDS entered kindergarten ready to read at higher

rates than children in non‐SEEDS groups (Lizakowski, 2005).



The SEEDS Professional Development model consists of training—and providing coaching to—early

childhood educators on how to effectively integrate research‐based language and literacy strategies

and materials into their classrooms. In 2012‐2013, Family Child Care Providers were engaged in

instruction and “Make and Take” workshops that taught strategies of both embedded instruction

(planned strategies that occur within the typical routines of the class day) and explicit instruction

(teacher‐directed activities that emphasize the teaching of a specific task), and to create a family

home environment that is designed to target early literacy predictors.

These predictors of later reading success include:

Conversation and Oral Language: The ability to produce or comprehend spoken language

Alphabet Knowledge: The ability to visually discriminate the differences between letters

and say the names and sounds associated with printed letters

Book and Print Rules: Refers to what children understand about how books and print work,

such as left‐right, front‐back, letters, words and that print has meaning

Phonological awareness: The ability to detect, manipulate, or analyze the auditory aspects

of spoken language, including the ability to distinguish or segment words, syllables, rhymes,

and beginning sounds

Vocabulary and Background Knowledge: A collection of words that relate to experiences

and knowledge that a child has of the world around him/her

The following diagram displays the five essential SEEDS quality interactions and the five predictors of

literacy.



SEEDS Plus

The SEEDS Plus program for FY 12‐13 was expanded to include a full academic year, and was

designed for “graduates” of the SEEDS of Early Literacy classes. In an effort to support teachers as

they worked to embed the SEEDS concepts into daily practice, this nine‐month course was designed

to focus on the SEEDS strategies through embedded and explicit instruction, modeling, practice, and

one‐on‐one weekly coaching.

The objectives of SEEDS Plus included:

Supporting teachers who work with children at risk for low language and literacy

opportunities.

Assessing and promoting the ongoing use of SEEDS strategies following prior SEEDS course

completion, for quality language and literacy support.

Promoting the use of Response to Intervention (RtI) strategies, that help early childhood

teachers recognize children who need tailored literacy support, and to respond in ways that

help the children experience early school success.

Increasing the number of children on target with early reading predictors.

Each participant in SEEDS Plus received:

15 instructional sessions.

20 on‐site coaching visits.

4 literacy labs and 6 children’s books to use in their centers.

In October, each SEEDS Plus participant conducted an initial benchmark assessment of children’s

emergent language and literacy skills using the Individual Growth and Development Indicators

(IGDI’s) assessment, to which was added assessments of letter names and letter sounds. Based on

this initial benchmark, SEEDS Plus participants chose up to five pre‐Kindergarten children to receive

tailored literacy‐based intervention strategies. These children’s progress was monitored every four

weeks throughout the program, with a winter benchmark assessment conducted in February and a

final spring benchmark assessment conducted in May.

Santa Cruz County’s SEEDS and SEEDS Plus programs have proven to be very effective at

strengthening classroom environments and practices, as well as influencing changes in children’s

skills on research‐based predictors of early reading.



Santa Cruz Reading Corps

AmeriCorps is a national service organization with about 100,000 members serving across the

United States to help meet critical needs in the areas of education, health, the environment,

disaster services, veterans, and economic opportunity. In the summer of 2012, First 5 Santa Cruz

County partnered with AmeriCorps to create the Santa Cruz Reading Corps (SCRC), which places 12

AmeriCorps volunteers in state preschool and transitional kindergarten classrooms in both the Live

Oak and Pajaro Valley Unified School Districts.

The focus of the SCRC is to promote strong literacy and language foundations for young children,

especially dual language learners. Local and statewide data indicate that well over half of 3rd grade

children in California—and Santa Cruz County—are not reading at proficiency. Research shows that

when students get off to a poor start in reading, they rarely catch up with other students. Happily,

research also shows that almost all children have the capacity to learn to read proficiently if

effective interventions are provided. Due to the fact that language development in the early years is

crucial to later reading success, the SCRC members are using the evidence‐based SEEDS of Early

Literacy curriculum to help boost the early literacy skills of children in English as they prepare to

enter kindergarten.

During the academic school year (running from September to May) SCRC members—called

Preschool Literacy Tutors—collaborate with the classroom teaching staff to enhance daily literacy

opportunities, and provide support to classrooms’ routines by implementing specific research‐based

strategies from the SEEDS of Early Literacy curriculum. Each tutor receives extensive training,

individualized coaching, and support to track and guide children in English language development

through one‐on‐one and small group interventions. SCRC tutors also facilitate Raising A Reader, the

weekly rotating book bag program that provides books and support for families to read aloud with

their children.

In addition to their daily work with students, tutors assess each child in their classroom three times;

once in October, once in early February, and once in May, in five areas of early reading predictors

(rhyming, alliteration, letter names, letter sounds, and vocabulary development). These assessments

help them select five children who receive tailored literacy‐based interventions on a daily basis.

Each of these children’s progress is monitored monthly to see if the interventions are effective. The

goal of the SCRC is to increase the number of children on target with early reading predictors.

Through all these efforts, children are provided the assistance they need to enter kindergarten more

school‐ready and to become fluent readers by 3rd grade.



The following figure presents the number of early childhood educators who participated in any of the

SEEDS trainings provided in 2012‐13, and cumulatively since 2007.

Figure 31: Number of Early Childhood Educators Who Have Completed SEEDS Trainings

THIS FUNDING CYCLE

2012‐2013

CUMULATIVE

TOTALS

2007‐2013

EARLY CHILDHOOD EDUCATORS

Number of SEEDS Quality Coaches providing literacy coaching, literacy environmental assessments, and professional development advising for SEEDS instruction, fidelity, and integrity during the year

14 52

Number of early childhood educators attending SEEDS of Early Literacy Courses 28 383

Number of early childhood educators attending the SEEDS Plus program 15 41

Number of Family, Friend or Neighbor (FFN) informal child care providers attending SEEDS of Early Literacy workshops

0 155

Number of Reading Corps tutors who received SEEDS training 12 12

TOTAL (unduplicated) 69 559

CHILDREN

Number of children in classrooms with a Reading Corps tutor 509 509

Source: Early Literacy Foundations (ELF) Initiative, 2007‐13.

The following figures show additional data about SEEDS‐Trained Early Childhood Educators

(participants in the “basic” SEEDS classes and SEEDS Plus classes, and SEEDS coaches) who have

been trained between 2007‐2013.

Figure 32: Number of SEEDS-Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007-2013)

Indicator: Number of early childhood educators who complete SEEDS training, and number of educators who are SEEDS coaches

Educators in State and Federally‐Subsidized

Classrooms

Educators in Licensed Family Child Care Homes and

Private/ Non‐Profit Centers

Unduplicated total, Spring 2007 – June 2013

207 185 392



Figure 33: Key Demographics of SEEDS-Trained Early Childhood Educators in Licensed Programs (2007-2013)

Primary Language

Educational Attainment

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Client and Assessment Data Entry Template, 2012‐2013.

N: (Language) N=407; (Education) N=376.

Raising A Reader (RAR), a weekly rotating book bag program for families, is implemented in classrooms

and family child care homes throughout the County. On a weekly basis, these sites provide children

with bags that are filled with various award‐winning books, which they borrow and bring home to their

parents. RAR provides training and information to parents and caregivers on how to effectively share

these books with their children at home, to help develop their children’s early literacy skills. The

majority of sites providing this RAR program also have early childhood educators who have been

trained in the SEEDS of Early Literacy curriculum, which means there are mutually complimentary

interventions on site to boost shared reading practices and impact children’s early literacy skills.

Figure 34: Number of Children Participating in Raising A Reader (2012-2013)

New Existing Total

Children 3,527 1,029 4,556


26.0%

48.9%

22.1%

2.9%

English Only

Spanish Only

Bilingual English/Spanish

Other

8.8%

9.3%

21.0%

26.6%

6.1%

10.9%

8.5%

4.0%4.8% No Formal Schooling

Less Than High School Diploma/GED

High School Diploma/GED

Some College

AA in non‐ECE/CD

AA in ECE/CD

BA in non‐ECE/CD

BA in ECE/CD

Some Graduate School or Postgraduate Degree

Indicator: Number of children participating in Raising A Reader



Preschool Classrooms

Research on teacher effectiveness shows that by focusing professional development on language

and literacy and social/emotional development, children are much better prepared for school and

have higher academic achievement. The first indicators of change are the language environment,

teacher‐child interactions, and language opportunities that teachers provide to children.

First 5 SEEDS Quality coaches are trained to independently assess SEEDS classrooms that are

teaching children ages 3‐5, using the Early Language and Literacy Classroom Observation Pre‐K Tool

(ELLCO Pre‐K). The ELLCO Pre‐K is used to assess the following five classroom components:

“Classroom Structure,” “Curriculum,” “Language Environment,” “Books and Book Reading,” and

“Print and Early Writing.” Items are scored along a 5 point scale, where 1 is deficient and 5 is

exemplary. From this scale, early childhood educators’ classroom scores can be categorized into

three levels, indicating their classroom environment provides low‐quality support, basic support, or

high‐quality support for language and literacy. In every Pre‐K SEEDS course since 2007, coaches

used the ELLCO to assess the classrooms of their mentees (early childhood educators receiving

SEEDS training) at the beginning and end of the semester.

In 2012‐13, only SEEDS Plus participants used the ELLCO Pre‐K tool. As the SEEDS Plus program is

designed for “graduates” of the SEEDS of Early Literacy classes, the following results demonstrate

the higher level of skill of these more experienced early childhood educators at pre‐assessment.

Across all components, classrooms showed improvements from the beginning of the

semester to the end. Even so, a high percentage of these SEEDS Plus classrooms were already

providing high‐quality support at the beginning of the year, demonstrating the skill of these

previously‐trained SEEDS educators.

Overall, the percentage of classrooms taught by SEEDS Plus participants that were rated as

having High‐Quality Support increased from 67% to 100%.

Among the individual sections of the ELLCO Pre‐K, by the end of the semester all of classrooms

(100%) were rated as having High‐Quality Support in “Classroom Structure,” “Curriculum,”

“Language Environment,” “Books and Book Reading,” and “Print and Early Writing.”

Family Child Care Settings

Early childhood educators from licensed family child care settings also participated in SEEDS training

and received SEEDS coaching. Their sites were observed at the beginning of their SEEDS training and

again at the end using the Child/Home Early Language and Literacy Observation (CHELLO), a tool

designed to rate the early literacy environment in home‐based child care settings of children ages

Indicator: Percentage of early education settings that provide high quality support for language and literacy



birth to 5 years. Two sections of the CHELLO tool were used to assess home‐based classrooms: the

Group/Family Observation section and the Literacy Environment Checklist. For the Group/Family

Observation section, items were scored along a 5 point scale, where 1 is deficient and 5 is

exemplary. Like the ELLCO analyses, early childhood educators’ classroom scores were categorized

into three levels, indicating their classroom environment provided low‐quality support, basic

support, or high‐quality support for language and literacy. Scores on the Literacy Environment

Checklist ranged from 1 to 26, and were similarly categorized into three levels of support (Poor, Fair,

Excellent).

In 2012‐13, there were two cohorts of licensed family child care providers who participated in

SEEDS; one in the fall and one in the spring. Educators in fall 2012 received a 7‐week SEEDS training,

7 coaching sessions, and conducted CHELLO assessments in their home‐based classrooms. Educators

in spring 2013 received home‐based coaching and training through three informal “Make and Take”

workshops that focused on the basic early literacy strategies called the “Big Five.” In this format

there were fewer requirements and they did not conduct the CHELLO assessments in their

programs.

Across all components, family child care home environments showed substantial improvements

from the beginning of the training to the end.

Results from the Group/Family Observation section showed that overall, the percentage of

family child care settings that were rated as having High‐Quality Support increased from 50%

to 92%.

Among the individual Group/Family Observation components, by the end of the semester the

majority of family child care settings were rated as having High‐Quality Support in “Physical

Environment for Learning” (92%), “Support for Learning” (83%), and “Adult Teaching

Strategies” (75%).

Scores on the Literacy Environment Checklist showed that the percentage of family child care

settings that were rated as having Excellent Support increased from 33% to 58%.

State Pre-K Classrooms

The SEEDS of Early Literacy has shown us that teachers of diverse educational backgrounds can be

trained to implement strategies to help children build a strong language and literacy foundation.

First 5 partnered with SEEDS state‐subsidized classrooms and found that, indeed, teachers have had

a positive effect on children’s language and literacy development. Participating classrooms assessed

children throughout the year in the three skill areas measured by the Individual Growth and

Indicator: Percentage of children who demonstrate research‐based predictors of later reading success



Development Indicators (IGDI’s) assessment tool (Picture Naming, Rhyming, Alliteration), and also in

the two skill areas of Letter Naming and Letter Sounds.

As the majority of students were dual language learners, many children were assessed in both

English and Spanish. In 2012‐13, there was an emphasis in all “SEEDS” classrooms on developing and

improving children’s vocabulary skills in English. Children whose primary language was Spanish were

assessed using the IGDI’s tool in both English and Spanish. Once children demonstrated proficiency

in their scores on the English‐language assessments, they did not continue taking the Spanish‐

language assessments.

Because of the number of English‐language learners in these classrooms, there was interest in

focusing on the early literacy skills of children when assessed in their primary language. When

looking at the percentage of children who were proficient in the five pre‐literacy skill areas (scoring

“At” or “Above” target level), results showed that:

On average, children who completed at least (any) two assessments improved in all five pre‐

literacy skill areas.

o When examining children in their primary language, English‐speaking children made the

greatest improvements in Letter Sounds and Alliteration.

o When examining children in their primary language, Spanish‐speaking children made the

greatest improvements in Alliteration and Rhyming (they were not assessed in the Letter

Naming or Letter Sounds skill areas).

By the final benchmark, Spanish‐speaking children demonstrated improvement in their

English language skills. When assessed in English, Spanish‐speaking children started with a

lower skill level than English‐speaking children, but by their last assessment they had made a

greater amount of improvement in Letter Sounds and Letter Naming, and equaled the

English‐speaking children’s amount of improvement in Rhyming and Alliteration.

Although these improvement results are greatly encouraging, it is important to note that

there are still some areas where only a small percentage of children are meeting targets for

later reading success. In particular, more work needs to be done to help Spanish‐speaking

children increase their English vocabulary (Picture Naming).

Additional analyses show similar results for children in classrooms taught by early childhood

educators trained in SEEDS Plus, and classrooms with Santa Cruz Reading Corps Preschool

Literacy Tutors.



Figure 35: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012-2013)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Individual Growth and Development Indicators (IGDI’s) Assessment

Tool, 2012‐2013.

* No Spanish assessments were analyzed in these two literacy skill areas, as they were not a requirement of these classrooms’ programs.

N: English N= Fall: Picture Naming (223), Rhyming (159), Alliteration (144), Letter Naming (190), Letter Sounds (179). N= Winter: Picture Naming (240), Rhyming (208), Alliteration (201), Letter Naming (200), Letter Sounds (182). N= Spring: Picture Naming (235), Rhyming (208), Alliteration (200), Letter Naming (201), Letter Sounds (186). Spanish/Spanish N= Fall: Picture Naming (180), Rhyming (134), Alliteration (129). N= Winter: Picture Naming (198), Rhyming (154), Alliteration (153). N= Spring: Picture Naming (169), Rhyming (154), Alliteration (153). Spanish/English N= Fall: Picture Naming (248), Rhyming (198), Alliteration (204), Letter Naming (229), Letter Sounds (225). N= Winter: Picture Naming (291), Rhyming (245), Alliteration (235), Letter Naming (219), Letter Sounds (212). N= Spring: Picture Naming (282), Rhyming (246), Alliteration (238), Letter Naming (232), Letter Sounds (231).

Summer Pre-K Academy

Pre‐school children who participated in the 4‐week Migrant Education Summer Pre‐K program were

assessed in their ability to recognize letter sounds in their primary language. Of the children who

participated in at least 14 sessions, 87% increased their letter sound recognition by at least five

letter sounds, and on average, they learned to recognize 15 new letter sounds by the time they left

the program.

Figure 36: Changes in Students’ Letter Sound Recognition Skills After Participation in the Migrant Education Summer Pre-K Program (2013)

Percentage of Students Who Increased Their Letter Sound Recognition By At Least 5 Letter Sounds

Average Number of Letter Sounds Recognized at Pre and Post Assessment

Source: Migrant Education Summer Pre‐K Program: Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2013.

N=95.

26.7% 27.2%33.7%

26.7%34.9%

29.5%

43.1%

58.1%

18.5%

28.1%32.8%

36.6%

44.9%

0%

20%

40%

60%

80%

100%

87.4%

0%

20%

40%

60%

80%

100%

2.8

17.8

0

5

10

15

20

Pre Post

Primarily English‐Speaking Children

English Assessment

Primarily Spanish‐Speaking Children

Spanish Assessment English Assessment



First 5 Santa Cruz County continued to support the use of the Child Snapshot as a vehicle for

communication among kindergarten, preschool, and family child care teachers about children who

are transitioning to kindergarten. The Child Snapshot supports children’s transition to kindergarten

by involving parents in the process and providing important information that helps kindergarten

teachers prepare for their incoming students.

In Spring 2013, a total of 906 preschool children had Child Snapshots completed—453 boys

(51%) and 434 girls (49%) (19 students were missing data on gender).

These children were drawn from 40 preschool programs throughout Santa Cruz County and

their Child Snapshot forms were shared with kindergarten teachers at 53 elementary schools

in Santa Cruz County and surrounding areas.

Relationship Between Family Activities and Children’s School Readiness

In 2012‐13, a new analysis was performed to determine if any of the family activities noted in the

Child Snapshot were correlated with children’s school readiness skills, as measured by the DRDP‐PS.

The DRDP‐PS assesses children’s school readiness skills in four domains: 1) Self‐Care & Motor Skills,

2) Self‐Regulation Skills, 3) Social Expression Skills, and 4) Kindergarten Academics. Results revealed

some statistically significant relationships between certain family activities and school readiness

skills.

Figure 37: The Impact of Family Activities on School Readiness

Kindergarten Academics

Family activities associated with greater readiness in the area of Kindergarten Academics

included:

Parents sang and told stories with children more times per week (N=376, r=.11, p<.05).

Parents reported eating family meals together more times per week (N=375, r=.11, p<.05).

Families visited the library (N=383, p<.05).

Self‐Care & Motor Skills

Family factors associated with greater readiness in the area of Self‐Care & Motor Skills

included:

Families drew, colored, painted, played with games and puzzles (N=385, p<.05).

Source: Applied Survey Research, Child Snapshot data report, 2013.

Indicator: Effectiveness of the Child Snapshot in assisting with children’s transition to kindergarten



Helping Kindergarten Teachers Get Prepared

Child Snapshot Kindergarten Teacher Survey

In order to help collect data on how useful the Child Snapshots were in assisting with the

communication of information between early childhood educators and kindergarten teachers, a

new survey was conducted in January 2013 that asked kindergarten teachers for their feedback on

how they used the Child Snapshots that they received at the beginning of the 2012‐13 school year.

This confidential online survey12 was distributed to almost all kindergarten teachers and elementary

school principals in the County, asking them if they’d received any Child Snapshots, how they used

these Child Snapshots, and whether and how they were useful. Key results from this survey are

provided below, which demonstrate the achievements being made to bridge children’s transition to

kindergarten.

Survey Population

41 kindergarten teachers and 6 principals from 28 elementary schools completed the survey.

On average, there were 4 kindergarten classrooms in each elementary school.

37 respondents said they’d received Child Snapshots, and on average, these respondents said

they’d received Child Snapshots for 10 incoming kindergarteners.

Survey Results

Results from the Child Snapshot Kindergarten Teacher Survey indicated that 92% of kindergarten

teachers used them in some way to assist with their incoming students’ transition to kindergarten.

The Child Snapshot helped kindergarten teachers with three key transition elements:

Communication with parents.

Preparation for the incoming students.

Formation of balanced kindergarten classes.

12 See Appendix C for a description of this Child Snapshot Kindergarten Teacher Survey.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS SERVICE INTEGRATION AND COMMUNITY STRENGTHENING


Service Integration & Community Strengthening


Framework analysis includes data regarding building

system integration efforts through training, shared data,

community events, and capacity‐building projects.

First 5 Service Integration

First 5 Santa Cruz County seeks to strengthen the system of care for families with children ages 0‐5 in

the County. One measure of the degree of current integration across the system is the number of

children who are served by multiple First 5 grantees. Sometimes this occurs because grantees cross‐

refer families, or because other agencies refer families into a coordinated network of First 5 services.

In 2012‐13, approximately 18% of children received services from multiple First 5 partners.

Not surprisingly, the agency with the highest child enrollment—Raising A Reader (with 4,670

children)—had the highest number of children who participated in other programs, including

Child Snapshot (638 children), Early Literacy Foundations Reading Corps classrooms (509

children), and Health Care Outreach Coalition (401 children).

Figure 38: Percentage of Children Receiving Services from Multiple First 5 Partners

Source: SUN database/CCD data for July 1, 2006 ‐ June 30, 2013.

N: (2006‐07) N=4,462; (2007‐08) N=5,214; (2008‐09) N=5,440; (2009‐10) N=5,762; (2010‐11) N=9,292; (2011‐12) N=8,382; (2012‐13) N=7,974.

Many health, social services, and early education providers in the County participated in workshops

on various social and community issues to better integrate services and improve customer service,

including 123 who participated in quarterly Brown Bag Lunches, and 28 who attended First 5’s

bi‐annual “Achieving Excellence in Customer Service” trainings.

12.8%

20.3%

13.0% 14.6% 17.8% 18.8% 17.9%

0%

10%

20%

30%

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12 2012‐13

Indicator: Number of families who receive services from multiple First 5 grantees

Indicator: Distribution of information to community service providers

SERVICE INTEGRATION & COMMUNITY STRENGTHENING

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT SERVICE INTEGRATION AND COMMUNITY STRENGTHENING


First 5 Fiscal Status and Sustainability

The following figure presents data for the unique number of clients served by each First 5 partner,

and the average cost per client.

Figure 39: Average Cost per Client, by Goal Area and Partner (2012-2013)

PARTNER JULY 2012‐ JUNE 2013 COSTS

NUMBERS SERVED AVERAGE COST PER INDIVIDUAL

PARENTS CHILDREN (AGES 0‐5)


TRIPLE P CHILDREN (AGES 6+)

TRIPLE P PRACTI‐TIONERS

TOTAL PARTICIPANTS

COST PER PARTICIPANT

HEALTHY CHILDREN

Healthy Kids Initiative $836,942 2,959 2,959 $283

Neurodevelopmental Clinic ‐ Dominican Interdisciplinary Child Development Program

$81,000 95 95 $853

STRONG FAMILIES

Families Together $623,242 114 163 277 $2,250

Triple P Services1 $519,848 586 339 461 1,386 $375

Training & Accreditation

$38,317 19 19 $2,017

Side‐By‐Side $92,500 25 25 $3,700

CHILDREN LEARNING AND READY FOR SCHOOL

Starlight Children’s Center $299,975 59 37 96 $3,125

Early Literacy Foundations Initiative

SEEDS of Early Literacy & SEEDS Plus

$282,274 57 57 $4,952

Santa Cruz Reading Corps $149,178 509 12 521 $286

Raising A Reader $220,512 4,670 4,670 $47

Migrant Education ‐ Summer Pre‐K Academy

$24,118 116 116 $208

Source: First 5 Santa Cruz County and SUN database/CCD data for July 1, 2012 – June 30, 2013, Optimal Solutions Consulting, 2013.

Note: The “Numbers Served” only include clients for whom enough data were collected to create a “Unique ID,” in order to prevent duplication within an agency. Triple P client numbers also include those who did not consent to share their evaluation data, as they are not likely to duplicate consenting clients. 1 Triple P provides services via several local practitioners and agencies, including three agencies that are already First 5 partners (Families Together, La Manzana Community Resources, and Mountain Community Resources). For Families Together, clients who only received Triple P services are reported as Triple P clients. If these clients also received other services from Families Together, they are reported again as clients for Families Together. Since Mountain Community Resources and La Manzana Community Resources received First 5 funding specifically to provide Triple P services, all of their clients are reported as Triple P clients in this table.

Indicator: Average cost per client



The balances on this statement were as of June 30, 2013. The Statement of Net Assets indicates that

net assets decreased by $1,260,210 from June 30, 2012 to June 30, 2013. This decrease in net assets

is part of the Commission’s planned use of its sustainability fund for providing programmatic

investments as set forth in the Strategic Plan. For the year ended June 30, 2013, the ending fund

balance was $4,464,198, a decrease of $1,343,446 from the prior year. The Commission’s fund

balance is allocated for the following categories:

Fund balance is committed for program contracts.

Figure 40: Statement of Activities, Fiscal Year 2012-2013

Revenue Prop 10 Allocation $ 2,254,575

Interest on Prop 10 Funds $ 17,620

Mental Health Services Act $ 218,586

Race To The Top $ 189,680

First 5 California Child Signature Program #2 $ 52,500

Foundation Grants $ 237,500

Other $ 25,388

Total Revenue $ 2,995,849

Expenses Program

Children Learning & Ready for School $ 1,141,926

Healthy Children $ 903,122

Strong Families $ 1,363,322

Service Integration $ 162,609

Program Support $ 388,107

Evaluation $ 157,662

Administration $ 218,702

Depreciation $ 3,844

Total Expenditures $ 4,339,295

Excess of expenditures over revenues $ (1,343,446)

Fund balance ‐ beginning of year $ 5,807,644

Fund balance ‐ end of year $ 4,464,198

Source: First 5 Santa Cruz County audited financial statements (2012‐2013).

Indicator: First 5 Santa Cruz County’s annual financial statements



Many partners maximize First 5 funding by using their funds to match or leverage additional

funding. In 2012‐2013, First 5 funding was leveraged by these partners to bring in the following

additional revenue.

Figure 41: Amount of Leveraged Investments, by Type (2012-2013)

SOURCE OF LEVERAGED FUNDING LEVERAGED FUNDING AMOUNT

Public agency ‐ Local $803,091

Public agency ‐ State $368,309

Business or Individual $366,021

Medi‐Cal Administrative Activities (MAA) $283,170

Public agency ‐ Federal $215,065

Early Periodic Screening Detection and Treatment (EPSDT) $143,465

Private Foundation $103,400

Educational Institution $57,370

Total $2,339,891Source: First 5 Santa Cruz County and First 5 partner Annual Progress Reports, 2012‐2013.

Figure 42: Total Amount of First 5 and Leveraged Investments (2012-2013)

Source: First 5 Santa Cruz County and First 5 partner Annual Progress Reports, 2012‐2013.

$4,045,835

$4,045,835$2,339,891

$2,339,891

$6,385,726

$0

$2,500,000

$5,000,000

$7,500,000

Total First 5 Investment Total Leveraged Investments First 5 and LeveragedInvestments Combined

Indicator: Amount of matched or leveraged investments reported by First 5 partners



Community Strengthening

2‐1‐1 is a centralized point of contact for Santa Cruz County residents to get information on local

services, and is accessible by phone or an online website. Trained specialists refer callers to local

agencies and services that match their needs, and also help relieve the burden on 9‐1‐1 during

disasters by providing non‐emergency information and referrals. This county program began in

2010, and is operated by the United Way of the Bay Area and funded by several local agencies

including First 5 Santa Cruz County.

Results show how effective this program has been in helping residents with their everyday needs

and concerns, and during emergency situations.

Since the 2‐1‐1 program began in Santa Cruz County in 2010, a total of 14,434 people have

called, with a total of 18,678 needs and 23,194 referrals.

Over the last two fiscal years (2011‐2013)13,

o Common types of needs included housing/utilities issues (30%), income

support/assistance (13%), individual, family, & community support (13%), health

care/mental health/addictions (13%), and food/meals (11%).

o The most common referrals were to individual, family, & community support (34%),

housing/utilities/homeless services (22%), and income support/tax assistance (13%).

Figure 43: Number of 2-1-1 Callers, Needs, and Referrals

Source: United Way of Santa Cruz County, Call Report, 2011‐2013.

13 In 2011‐12, First 5 recategorized the types of needs and referrals so that they more closely corresponded. Therefore, these cumulative results only include the years that have used these new categories (2011‐2013).

5,157 5,7977,347

4,5745,745

7,7564,703

7,136

8,091

14,434

18,678

23,194

0

5,000

10,000

15,000

20,000

25,000

Number of Callers Number of Needs Number of Referrals

TOTAL

2012-13

2011-12

2010-11

Indicator: Access and utilization of the 2‐1‐1 program



Figure 44: Types of 2-1-1 Callers’ Needs (2011-2013)

Figure 45: Types of 2-1-1 Referrals (2011-2013)

Source: United Way of Santa Cruz County, Call Report, 2013.

N: (Caller’s Needs)=12,881; (Types of Referrals)=15,847.

29.5%

13.4%

13.0%

12.6%

11.2%

9.5%

2.4%2.0%

6.4%Housing/Utilities

Income Support/Assistance

Individual, Family, & Community Support

Health Care/Mental Health/Addictions

Food/Meals

Legal, Consumer and Public Safety

Clothing/Personal/Household Needs

Employment Services

Other

34.1%

21.6%

13.4%

9.5%

7.9%

4.4%2.7%

1.7%4.7%

Individual, Family, & Community Support

Housing/Utilities/Homeless Services

Income Support/Tax Assistance

Legal, Consumer and Public Safety, Disaster Services

Health Care / Dental / Mental Health / Addictions

Employment Services

Food/Meals

Clothing/Personal/Household Needs

Other

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES


PART 2: PARTNER PROFILES

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT


FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES


PARTNER PROFILES

This section of the report provides a snapshot of each First 5 partner’s work between July 1, 2012

and June 30, 2013.

At the beginning of the 2012‐13 contract period, scopes of work were developed with each partner

which detailed each program’s target population, the number of people to be served, primary

programmatic activities, outcome objectives, methods of measurement, and the timing of data

collection activities. Partners reported their outcome data biannually or annually, using the SUN

database, customized Excel forms, or partner‐specific reports. In addition, a narrative template was

provided to partners to submit qualitative information on the progress of their services. When

collecting data for their outcome objective, some programs did not administer their assessment

tools to every participant. For this reason the number of participants reported in their outcome

measurement may differ from the total number of participants who were served.

The purpose of the Partner Profiles is to highlight the work that each partner conducted in Fiscal

Year 2012‐13. Organized by goal area (Healthy Children, Strong Families, and Children Learning and

Ready for School), each profile briefly lists:

Description of the program

Population served

Client outcome objectives achieved (and in a few cases, also program objectives achieved)

Readers will note that in many cases, data that were presented in the Strategic Framework section

are presented here again with the intent of summarizing the meaningful work that each of the

partners carried out in 2012‐13.

Finally, it should be noted that these profiles only provide an overview of the innovative work that

each partner or initiative carries out, and that more comprehensive detail about each partner’s

progress is provided in their annual report to First 5.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT HEALTHY CHILDREN ‐ HEALTH CARE OUTREACH COALITION


“[One couple] has 6 children in the family, and the older children qualified for Healthy Families. However, with the parent’s joint income, the two younger children did not qualify for Healthy Families. The mother applied for Healthy Kids [for these younger children] and was able to receive benefits. She was so grateful to receive these benefits, as both children have been sick and have had to go to the emergency room before receiving these benefits. She was very impressed with the program, and has referred other people.”

- Health Care Outreach Coalition, Annual Progress Report

“It is great to be a CAA. Especially when you help someone relieve their stress. Just when they think there is no hope, you happen to show them that there is a dim light at the end of the tunnel.”

- Certified Application Assistor (CAA)

Healthy Children

Healthy Kids Initiative

Health Care Outreach Coalition

Program Description

The Health Care Outreach Coalition (HCOC) provides assistance with application and enrollment in

public health insurance to income‐eligible families. Through community outreach workers called

Certified Application Assistors (CAAs), children

from families earning up to 300% of the Federal

Poverty Level receive assistance in applying for

Medi‐Cal, Healthy Families (currently being

folded into Medi‐Cal for Families), and the local

Healthy Kids health insurance plan.

Additionally, HCOC staff participate in

community events and respond to business and

community agency requests for presentations

and additional information regarding health

insurance. HCOC assists in the management of

the One‐e‐App online application system,

providing training and technical assistance to all

CAAs.

Population Served

2012‐2013

Children 2,959


Outcome Objective: Children will be assisted in applying for public health insurance

2012‐2013

Number of children assisted with new enrollments 3,116*

Source: Health Care Outreach Coalition, Enrollment and Utilization Report, 2013.

* The number of children in this analysis may be slightly different than the total number of unduplicated children served, since families may come to HCOC for enrollment assistance more than once in the fiscal year. Enrollment and utilization results represent the status of children’s applications as of 9/13/13.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES HEALTHY CHILDREN ‐ HEALTH CARE OUTREACH COALITION


Outcome Objective: Children will be enrolled in public health insurance

2012‐2013

By June 30, 2013, 75% of the children ages 0‐5 who received assistance to apply will be enrolled in a public health insurance program

95.4%

N=1,956

Source: Health Care Outreach Coalition, Enrollment and Utilization Report, 2013. Results represent the status of children’s applications as of 9/13/13.

Outcome Objective: Children will be renewed in public health insurance

2012‐2013

By June 30, 2013, 75% of the children ages 0‐5 who received assistance to apply will be renewed in a public health insurance program

92.2%

N=1,160


System Outcome: Children will utilize public health insurance

2012‐2013

85% of children ages 0‐5 renewing in public health insurance between July 1, 2012 and June 30, 2013, will have utilized care prior to renewal

99.0%

N=1,102


Note: Utilization results exclude clients with missing data.

The following chart presents the percentage of applicants who were enrolled in health insurance,

the percentage who re‐enrolled in insurance, and the percentage who utilized their benefits.

Figure 46: HCOC Child Health Insurance Enrollment, Renewal, and Utilization Percentages

Source: Applied Survey Research, First 5 Santa Cruz County Final Reports, 2007 ‐ 2010. Health Care Outreach Coalition, Enrollment and Utilization Report, 2011‐2013. Note: The number of children in this analysis may be slightly different than the total number of unduplicated children served, since families may come to HCOC for enrollment assistance more than once in the fiscal year. Enrollment and utilization results represent the status of children’s applications 2‐3 months after the end of each fiscal year. Utilization results exclude clients with missing data. N: (Enrollment) 2007=678; 2008=580. 2009=730, 2010=1,528, 2011=1,944, 2012=2,316, 2013=1,956; (Renewal) 2007=496; 2008=530. 2009=592, 2010=826, 2011=902. 2012=1,088, 2013=1,160; (Utilization) 2007=471, 2008=514. 2009=555, 2010=789, 2011=829, 2012=1,013, 2013=1,102.

99.6%

97.9%

99.6% 99.4%

96.6%

99.6% 99.0%

93.8%

98.5%

98.0% 93.7%92.1%

92.3% 92.2%

85.7%87.9%

85.6% 85.5%

89.0%

94.1%95.4%

70%

75%

80%

85%

90%

95%

100%

June 2007 June 2008 June 2009 June 2010 June 2011 June 2012 June 2013

Percent who utilized care prior to renewal in an insurance program

Percent who were renewed in an insurance program

Percent who were enrolled in an insurance program

Utilization Outcome Objective: 85%

Enrollment & Renewal Outcome Objectives: 75%



Newborn Enrollment Project: Baby Gateway

Baby Gateway—the Newborn Enrollment Project—operates in three local hospitals with funding and

support provided by First 5 of Santa Cruz County: Watsonville Hospital, Dominican Hospital, and Sutter

Maternity & Surgery Center of Santa Cruz. The main goals of the project are to provide enrollment

assistance to mothers and their newborns, as well as to establish a seamless Medi‐Cal coverage

process for Medi‐Cal‐eligible newborns, and to link those newborns to a medical home, all before they

leave the hospital.

In addition, all new mothers receive the First 5 “Kit for New Parents” containing expert guidance for

raising healthy infants and children. In particular, parents are oriented to the “What To Do If My Child

Gets Sick” booklet, which provides information in utilizing primary care appropriately, and clarifies

what issues should prompt a visit to the emergency room, and which should be handled in the medical

home.

Newborn Enrollment Results

Data from 2012‐13 show how successful this program has been in providing these services to Santa

Cruz County’s mothers and newborns.

Of all 3,155 births that occurred in Santa Cruz County at these hospitals in 2012‐13, 73% of

mothers received a newborn visit while in the hospital, and 56% received a “Kit for New

Parents.”

Of all 1,748 mothers with Medi‐Cal births during 2012‐13, 83% were assisted to complete a

Medi‐Cal application for their new babies.

Of the 1,453 mothers who were assisted to complete a Medi‐Cal application for their

newborns, nearly all applications (99.8%) were approved, and 94% were assigned a primary

care provider for their child before discharge from the hospital.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES HEALTHY CHILDREN ‐ HEALTH CARE OUTREACH COALITION


Figure 47: Newborn Enrollment Project Statistics (2012-2013)

PROGRAM COMPONENT WATSONVILLE

COMMUNITY

HOSPITAL

DOMINICAN

HOSPITAL SUTTER

MATERNITY &

SURGERY CENTER OF SANTA CRUZ

TOTAL

Total Number of All Births in Santa Cruz County

1,344 869 942 3,155

Total Number of Medi‐Cal Births 1,144 358 246 1,748

NUMBER PERCENT OF ALL MEDI‐CAL BIRTHS

Number of Completed Newborn Medi‐Cal Applications

982 328 143 1,453 83.1%

NUMBER PERCENT OF ALL MEDI‐CAL

APPLICATIONS

Number of Approved Newborn Medi‐Cal Enrollments 981 326 143 1,450 99.8%

Number of Denied Newborn Medi‐Cal Applications 1 2 0 3 0.2%

Number of Pending Newborn Medi‐Cal Applications 0 0 0 0 0.0%

Number of Newborn Medi‐Cal Applicants with an Assigned Primary Care Provider

1,364 93.9%

NUMBER PERCENT OF ALL COUNTY BIRTHS

Total Number of Newborn Visits (regardless of insurance status)

1,203 712 388 2,303 73.0%

Number of Kits for New Parents Distributed

841 605 329 1,775 56.3%

Source: Health Care Outreach Coalition, Newborn Enrollment Statistics, 2013.



Emergency Department Visits

The services provided by the Newborn Enrollment Project may also have had an effect on the use of

the Emergency Department (ED) for children less than one year old.

ED visits typically peak during the first two quarters of each year. Consequently, when comparing ED

visits at a hospital before and after the launch of Baby Gateway, it was important to evaluate the

same quarter when making comparisons between years. In the following analysis, results for

Quarter 1 were compared.

Baby Gateway was launched at Watsonville Community Hospital in August 2009. When

comparing the data for Quarter 1 of 2009 and 2013, the number of ED visits for infants under

one year dropped from 573 to 367 (a 36% decrease).

Similarly, after Baby Gateway was launched at Dominican Hospital in January 2011, ED visits

for infants under one year dropped from 186 to 176 (a 5% decrease).

Figure 48: Number of Emergency Department Visits (Infants Less Than One Year Old)

Source: Health Improvement Partnership of Santa Cruz County, Healthy Kids Biannual Evaluation, July 2012 – June 2013.

573

632

552 558

506528

471

421 424446

349381 395

342

428401

367

218184

151171

199

146116

168186

148116

137163

112128 118

176

0

100

200

300

400

500

600

700

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1

WatsonvilleCommunityHospital

DominicanHospital


Dominican and Sutter Hospitals


Watsonville Community

Hospital

2009 2010 2011 2012 2013

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES HEALTHY CHILDREN ‐ DOMINICAN INTERDISCIPLINARY CHILD DEVELOPMENT PROGRAM


“One mom was initially very resistant to having her son receive standardized testing through our program. She ended up being delighted to have the results to present to the school district to advocate for her son to receive special resource assistance when he starts kindergarten in the fall.

…[The DICDP’s] successful interagency collaboration ensures that our highest-risk population of court dependent children are receiving appropriate early intervention services and are not falling through the cracks. Early intervention services are critical in optimizing long-term health and mental health.”

- Dominican Interdisciplinary Child Development Program, Annual

Progress Report

Neurodevelopmental Clinic - Dominican Interdisciplinary Child Development Program

Program Description

The Dominican Interdisciplinary Child Development Program is an innovative, coordinated approach to

address the neurodevelopmental needs of very vulnerable infants and toddlers in the foster care system.

Nationally, almost one in five children face developmental disabilities or disabling behavioral problems

before age eighteen, but fewer than half of these children are identified before the age of five.14 On the

other hand, about one‐third of California children who receive early intervention services before the age

of three do not require additional intervention during the preschool years or when they enter

kindergarten.15 We know early intervention works, yet children who have already endured abuse and

neglect typically do not receive the early assessment and coordinated services they need. Children with

disabilities are more likely to be abused and neglected and

yet, once in the system designed to protect them, their

needs may go unaddressed – thereby missing a critical

window of opportunity to set a healthy life course.

In order to assess, intervene, and treat developmental

and social/emotional issues for children ages 0‐5 in

foster care in Santa Cruz County, Dominican Pediatrics

established a coordinated and multidisciplinary

neurodevelopmental consultative care clinic called the

Dominican Interdisciplinary Child Development

Program (DICDP). DICDP is a collaboration between the

Dominican Pediatrics Program, Packard Children’s

Hospital Development and Behavior Program, Santa

Cruz County Children’s Mental Health, Santa Cruz County

Family and Children’s Services, and First 5 Santa Cruz County.

DICDP began providing services in October 2011, with an interdisciplinary team that focuses on early

intervention to address the needs of young children entering foster care, and to provide

comprehensive services to these foster children, their families, and foster families. To this end, all

children in Santa Cruz County under the age of 6 who are in foster care or who are involved with

Child Protective Services (CPS) are referred to the program. The following services are provided:

A therapist from County Mental Health meets with the child and foster family for a mental

health assessment of the child.

A Stanford clinical psychologist meets with the child, biological family, and foster family to

discuss developmental and behavioral history and milestones.

14 American Academy of Pediatrics (2006). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics, 118 (1), 405‐420.

15 Centers for Disease Control and Prevention, “Child Development: Using Developmental Screening to Improve Children’s Health,” Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/child/improve.htm (accessed July 22, 2008).

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT HEALTHY CHILDREN ‐ DOMINICAN INTERDISCIPLINARY CHILD DEVELOPMENT PROGRAM


Standardized developmental and behavioral testing is conducted. The results of the testing and

recommendations are provided to the family and foster family at the end of the assessment.

A follow‐up consultative report is provided to all members of the interdisciplinary team, and

the biological and foster families.

A county mental health therapist provides ongoing counseling to those children needing

therapy services.

A Dominican Licensed Clinical Social Worker coordinates and case manages the program.

Children needing developmental services (e.g., occupational therapy, physical therapy,

speech therapy, special education) are referred to local resources and the school district in

which they reside.

Any identified medical services (e.g., audiology, ophthalmology) are coordinated through the

primary care provider.

Population Served

THIS FUNDING CYCLE

2012‐2013

CUMULATIVE

TOTALS*

2011‐2013

Children (ages 0‐5) 95(ages 6+) 14

(ages 0‐5) 146(ages 6+) 16


* Due to the increased confidentiality requirements of this partner, it is not possible to track clients who may be duplicated across fiscal years for this agency.

In the following results, data from the past two fiscal years (2011‐2013) have been aggregated in

order to present a more robust description of this program’s outcomes.

Program Objective: Provide professional development and build the capacity of the community to support services

2011‐2013

Between July 1, 2011 and June 30, 2013, begin building the capacity of the community to support the services that are recommended for the Clinic’s child clients.

Provided 7 trainings for partner agencies’ staff, regarding appropriate child development, assessments, setting goals, and appropriate treatments and strategies.

A Stanford clinical psychologist and pediatrician provided the trainings.

The training topics were: attachment risks for foster care children, pervasive developmental delay, ADHD, DSM 5 update, developmental prospective, and fetal alcohol spectrum disorder.

The 2‐hour trainings took place at the county health building, with approximately 100 participants at each workshop.

The trainings were well received and will continue bimonthly. Source: Dominican Interdisciplinary Child Development Program 2012‐13 Annual Progress Report.



Program Objective: Improve speed of services

2011‐2013

Between July 1, 2011 and June 30, 2013, begin implementing processes that reduce the time before children receive their recommended interventions.

Processes were implemented to improve the speed of services, including:

CPS has been submitting the DICDP consultation reports to the court for the judge to read.

Team members met routinely to discuss operational procedures. This interagency collaboration was successful in that all team members worked together to achieve mutual goals.

DICDP continued to work on expediting the school district IEP process, which is now faster. Two team members talked with the appropriate school district personnel to streamline the process.

The Individual community support plan (ICSP) is used for every referral.

When the child is recommended to receive mental health services, they are immediately served.

Source: Dominican Interdisciplinary Child Development Program 2012‐13 Annual Progress Report.

Program Objective: Develop a portrait of the child population

2011‐2013

Between July 1, 2011 and June 30, 2013, serve 150 children and provide key data about the clients, to enable the development of population profiles as clients progress through their treatment program.

146 children ages 0‐5 in foster care were assessed by a Stanford clinical psychologist

Children received case management and coordination to increase access to needed services for the children, foster families and birth families

Children were referred to specialized services based on the assessment findings

Source: Dominican Interdisciplinary Child Development Program 2012‐13 Annual Progress Report.


PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT HEALTHY CHILDREN ‐ DOMINICAN INTERDISCIPLINARY CHILD DEVELOPMENT PROGRAM


Figure 49: Demographics of the Children (Ages 0-5) Participating in the DICDP (2011-2013)

Gender Primary Language

Race/Ethnicity Age


N: (Gender, Race/Ethnicity, Age)=146; (Language)=145.

Figure 50: Percentage of Children in DICDP (Ages 0-5) With These Diagnoses and Services, at Intake (2011-2013)



** The number of children receiving Physical Therapy at intake was not measured in 2012‐13

N: (IEP, ADHD, Occupational Therapy, Developmental Disability Services)=146; (Delayed, Severely Delayed)=141; (Autism)=95; (Physical Therapy)=51.

Male43.8%

Female56.2%

English89.0%

Spanish11.0%

Latino / Hispanic, 54.1%

Caucasian / White, 40.4%

Other, 5.5% 12.3%

27.4%

13.7%13.7%

15.8%

17.1%< 1 year old

1 year old

2 years old

3 years old

4 years old

5 years old

12.8%

1.4%4.8% 2.1% 2.0%

17.7%

4.3% 4.8% 3.2% 2.7%

30.5%

5.7% 4.8% 4.8%3.2% 2.7% 2.1% 2.0%

0%

5%

10%

15%

20%

25%

30%

35%

"Delayed"Developmental

Level*

"SeverelyDelayed"

DevelopmentalLevel*

Diagnosed withADHD

ReceivingOccupational

Therapy

Diagnosed withAutism

Has an IEP ReceivingDevelopmental

DisabilityServices

ReceivingPhysical

Therapy**

TOTAL 0‐5

Ages 3‐5

Ages 0‐2



Figure 51: Percentage of Children in DICDP (Ages 0-5) Provided With These Referrals (2011-2013)


* San Andreas Regional Center (SARC)

** The number of children referred to Occupational Therapy was not measured in 2011‐12.

N: (All referrals except OT) =146; (Occupational Therapy)=95.

0.7%2.7%

0.7% 2.1% 2.1% 0.7%

15.1%

2.1%

2.1%1.1% 1.1%

0.7%0.7%

15.8%

4.8%

2.8% 3.2% 3.2%1.4% 0.7%

0%

5%

10%

15%

20%

School district(IEP/IFSP

development)

Triple P(Parenting skills)

Audiology SARC*/Early Start(Developmentaldisability services)

OccupationalTherapy**

Ophthalmology Genetics

TOTAL 0‐5

Ages 3‐5

Ages 0‐2

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRONG FAMILIES – FAMILIES TOGETHER


“I think we should be most proud of how we value and support the parent-child bond and the desire of parents to be the best parents they can be, even in the most challenging of situations.

We offer hope, validation, skill building, parenting education, resources, collateral treatment and compassion to parents, …allowing them to better hear the needs and feelings of their children.”

-Families Together, Annual Progress Report

Strong Families

Families Together

Program Description

Families Together provides an alternative, voluntary and prevention‐focused way for Santa Cruz

County to respond to reports of abuse and neglect received by Family and Children’s Services (FCS).

Of all the referrals to the child welfare screening unit, only about 8% meet the necessary criteria to

receive services from FCS. However, many of the families that don’t qualify for services from FCS still

have needs and circumstances that place them at risk

for future incidents of child abuse and neglect. By

assisting these families, Santa Cruz County can

intervene early, before family difficulties escalate to

the point of maltreatment, in order to increase child

safety, engage families in decision‐making, and to

support healthy child development.

Encompass Community Services (formerly Santa Cruz

Community Counseling Center) is the lead agency for

Families Together. Other collaborative partners, such as

Family and Children’s Services, a division of the Human Services Department (HSD), Health Services

Agency, and Families in Transition also play critical roles in the program.

Most families are referred through the Child Welfare System, but they participate in Families Together

voluntarily. Beginning in 2012‐13, Families Together also began accepting a limited number of

“community‐referred” families (e.g., through Head Start, Early Head Start, or public health nurses).

This home visiting program includes comprehensive intake and risk assessment, development of a

tailored case plan, parent support and education, child development activities, and periodic

assessments. Using a strengths‐based approach, participating families are encouraged to identify goals

and objectives that will support healthy family relationships, child health and safety, positive

parenting, family literacy and school readiness.

Population Served

2012‐2013

Families Together Pathway Subtotal All Pathways

(unduplicated)

Participated in Triple P*

Total All Pathways + Triple P

(unduplicated) Brief Intensive Pending

Parents/Guardians 35 71 8 114 51 127

Children 47 106 12 163 (ages 0‐5) 63 (ages 6+) 65

(ages 0‐5) 177

Source: SUN database/CCD data for July 1, 2012 – June 30, 2013, Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research).

Note: The risk assessment results guide the pathway assignment decision: families who score Low or Moderate work within the Brief Pathway with a Family Support Specialist for 3‐6 months. Those who score High or Very High work within the Intensive Pathway for up to 12 months, also with a Family Support Specialist.

* Although most of the clients who participate in Triple P through Families Together are also enrolled in Families Together, it is possible for clients’ household members (who are not themselves enrolled in Families Together) to participate in Triple P. For this evaluation report, Triple P is one of the only funded partners that reports the number of children ages 6+ who received services.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – FAMILIES TOGETHER


Outcome Objective: Families receive referrals, initial assessments, and assigned services

Program Objectives 2012‐2013

Accept referrals for at least 280 families per year who will be referred from Family and Children’s Services to the Differential Response Program

2521

Provide outreach and engage at least 75% of families referred to the Differential Response Program in an initial meeting

74.8%

N=147

At least 150 primary caregivers per year will participate in the Differential Response Program

114

Source: SUN database/CCD data for July 1, 2012 – June 30, 2013; Families Together Referral and Initial Engagement Form, 2013, and Annual Progress Report, 2013. 1 This number refers to participant referrals from Family and Children’s Services, not unique participants. If the same participant was referred more than once, each referral is tracked separately. In 2013, Families Together also began accepting referrals from a few partner agencies, but these referrals are not included in this number, as the Program Objective is specific to referrals from Family and Children’s Services. Since January 2013, 11 additional referrals from the new Community Referral track have turned into active cases.

Figure 52: Case Flow Diagram (2012-2013)

Cases Referred to Families Together (FT): 2521

Contact and

meeting plans still

in progress

7

Contact ended:

(Unable to contact, case reopened in CWS, client declined, or Ineligible for services)

Referral Closed

135

Contacted and initial meeting scheduled

110

Contact ended:

(Did not show up to meeting, or met but declined to participate)

Referral Closed

5

Consented to participate in FT

OR

Referred to Primeros Pasos2:

1053

Source: Families Together Referral and Initial Engagement Form, 2013. 1 This number refers to participant referrals from Family and Children’s Services, not unique participants. If the same participant was referred more than once, each referral is tracked separately. In 2013, Families Together also began accepting referrals from a few partner agencies, but these referrals are not included in this number, as the Program Objective is specific to referrals from Family and Children’s Services. Since January 2013, 11 additional referrals from the new Community Referral track have turned into active cases. 2 Primeros Pasos is a companion program to Families Together serving participants with intensive substance abuse issues. 3 Due to the complicated nature of tracking the ever‐changing status of each referral, this number represents the best estimate of the status of all clients, using the program’s Referral and Initial Engagement Form.



Outcome Objective: Families demonstrate decreased levels of risk

In Families Together, risk assessment serves a variety of purposes. The assessments help staff link

parents with the appropriate service pathways, such as brief or intensive services. Follow‐up

assessments help assess whether risk has been reduced.

Client Outcome Objective 2012‐2013

75% of primary caregivers who participate in the Differential Response Program will demonstrate decreased risk based on a final assessment

79.3%

N=29


As seen in the following figure, the Structured Decision Making: Family Prevention Services Screening

Tool used in the Families Together program is helping to show that families reduce their level of risk

while in the Families Together program.

In 2012‐13, 79% of parents were found to have lower levels of risk at reassessment than at

baseline.

Figure 53: Percentage of Families Together Participants Who Showed Decreased Risk of Child Maltreatment


Notes: Although very few families had a “low risk” score at baseline, these families were omitted from these analyses so that only those who could demonstrate reduced risk on the tool remained in the analysis.

Due to inaccuracies in data entry in 2006‐07, clients with baseline assessments before 7/1/07 were omitted from this analysis.

In 2008‐09, this risk assessment included both families receiving intensive services and those receiving brief intervention services. Long‐term clients were assessed at intake, 6 months, and 12 months, and clients receiving brief interventions were assessed at intake and the end of services.

A second view of these risk assessment data involves a comparison of the percentage of families at

each level of risk over three assessments (baseline, first reassessment, and second reassessment).

Since each year’s analysis is constrained by fairly small sample sizes, several years of data have been

aggregated in order to present a more robust portrait of the extent to which Families Together

participants are reducing their risk for future involvement with the child welfare system.

71.1%60.6% 63.0%

76.5% 74.7%79.3%

0%

20%

40%

60%

80%

100%

2007/08(N = 45)

2008/09(N = 66)

2009/10(N = 128)

2010/11(N = 81)

2011/12(N = 75)

2012/13(N = 29)



As can be seen, 61% of families were assessed as being “high risk” or “very high risk” upon intake,

and this dropped to 12% by the second reassessment, indicating that the program is helping families

reduce their level of risk.

Figure 54: Change in Families Together Participants’ Risk Levels Over Time (2007/08 - 2012/13)


* Although very few families had a “low risk” score at baseline, these families were omitted from these analyses so that only those who could demonstrate reduced risk on the tool remained in the analysis.

Note: Due to inaccuracies in data entry in 2006‐07, clients with baseline assessments before 7/1/07 were omitted from this analysis. Results for the 3rd reassessment were not reported due to the low number of clients.

Outcome Objective: Families do not experience a high rate of recurrence of abuse

Client Outcome Objective 2012

At least 95% of families who participate in the Differential Response program will not have a substantiated allegation of abuse at least 6 months after case closure.

94.9%

N=78

Source: Santa Cruz County Human Services Department. Families Together: Substantiated Child Abuse Study, 2013.

Note: Data are from the 2012 calendar year, in order to allow at least a 6 month period after case closure.

Of the 78 families who received services from Families Together and had their cases closed in

the 2012 calendar year:

o 95% did not have a substantiated allegation of maltreatment within six months after case

closure. This figure is comparable to what was observed in the previous years.

o An additional study found that 17% had been re‐referred to child welfare within six

months after their exit from Families Together.

These results indicate that although some families are re‐referred to child welfare after

exiting from Families Together, the rate of substantiated abuse is low. This suggests that

even though families are still experiencing high risk factors that lead to a child welfare report,

they may have gained skills and resources during their participation in Families Together that

prevent court‐mandated involvement with child welfare. A further study of the factors

related to these re‐referrals that are not substantiated could support the program and the

child welfare system to best serve the families.

30.4%36.0%

39.1%

49.7% 51.8%46.1%

17.9%

8.6%14.7%

2.0% 3.6%

0%

10%

20%

30%

40%

50%

60%

70%

Baseline* (N=373) 1st Reassessment (N=296) 2nd Reassessment (N=139)

Low Risk

Moderate Risk

High Risk

Very High Risk



Figure 55: Percentage of Families Together Participants Who Do Not Have a Substantiated Allegation of Maltreatment Within 6 Months After Case Closure



N: (2008)=61, (2009)=74, (2010)=82, (2011)=72, (2012)=78.

Figure 56: Percentage of Families with Child Welfare Issues Within 6 Months After Exit from Families Together (2012)



N=78.

Outcome Objective: Children have health insurance and a medical home

Client Outcome Objective 2012‐2013

98% of children ages 5 and under have health insurance by exit from the program. 100% N=90

98% of children ages 5 and under will have a medical home by exit from the program. 98.9% N=90

Source: Families Together, Annual Narrative Report, 2012‐13.

95.1% 92.0% 96.3% 91.7% 94.9%

0%

20%

40%

60%

80%

100%

2008 2009 2010 2011 2012

16.7%5.1%

0%

20%

40%

60%

80%

100%

Re‐Referral to Child Welfare Substantiated Allegation of ChildMaltreatment



Outcome Objective: Families will have access to parenting support services structured by the Triple P curriculum

In the analyses of the following Triple P outcomes, all the assessment data since the

commencement of the Triple P at Families Together have been aggregated (January 2010 – June

2013) in order to present a more robust portrait of the extent to which the Triple P participants at

Families Together are developing their parenting skills and knowledge.

Families Together participants benefited from Triple P services.

Families Together clients who completed the Triple P program reported statistically significant

improvements and moderate to large degrees of change in their use of positive parenting styles, as

measured by the Parenting Scale.

Figure 57: Parents’ Use of Positive Parenting Styles (Families Together: 2010-2013)

Source: Triple P data from the Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Families Together participants also reported a statistically significant decrease in the frequency and

number of problematic child behaviors, as measured by the Eyberg Child Behavior Inventory (ECBI).

These results represent a moderate to large magnitude of change.

Figure 58: Parents’ Perceptions of Child Behavior (Families Together: 2010-2013)

Frequency of Problematic Child Behaviors

3.12.6

1

2

3

4

5

6

7

All Parents** (N=42)

Pre Post

121.3100.7

36

72

108

144

180

216

252


Pre Post


Behavior always occurs

Behavior never occurs


Lower is

“Better”

Lower is

“Better”







Client Satisfaction with Triple P Services

Families Together parents receiving Triple P services reported high levels of satisfaction with the

program.

On average, parents gave the highest rating to the question, “If you were to seek help again,

would you come back to this organization?” (6.68 out of 7), closely followed by the quality of

service they and their child received (6.64).

Figure 59: Parents’ Satisfaction with Various Aspects of the Triple P Program (Families Together: 2010-2013)

Source: Triple P data from the Parent Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013.

13.8

8.20

6

12

18

24

30

36


Pre Post

6.28

6.43

6.68

6.45

6.45

6.64

1 2 3 4 5 6 7

13. How would you describe your feelings at this point about yourchild's progress? (N=39)

11. Has the program helped you to develop skills that can beapplied to other family members? (N=40)

10. If you were to seek help again, would you come back to thisorganization? (N=40)

7. Has the program helped you to deal more effectively withproblems that arise in your family? (N=42)

6. Has the program helped you to deal more effectively with yourchild's behavior? (N=42)

1. How would you rate the quality of the service you and your childreceived? (N=42)

All behaviors were a problem



Lower is

“Better”

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – TRIPLE P


Triple P – Positive Parenting Program

Program Description

Triple P (Positive Parenting Program) is a comprehensive, evidence‐based parenting and family

support system designed to increase parents’ confidence and competence in raising children, improve

the quality of parent‐child relationships, and make practical, effective parenting information and

interventions widely accessible to parents. The Triple P system can reach an entire community, as well

as individual families who need more intensive services, through the following five levels of

interventions:

Level 1: Universal Triple P disseminates information about positive parenting to the entire

community through a media‐based social marketing campaign.

Level 2: Selected Triple P provides brief information through one‐time consultations (Level 2

Individual) or a series of Seminars on general parenting topics (Level 2 Seminars).

Level 3: Primary Care Triple P offers brief, targeted parent education and skills training

through Workshops on specific topics (Level 3 Workshops) or 3‐4 brief consultations on an

individual basis (Level 3 Individual) or in a group with other families (Level 3 Brief Group).

Level 4: Standard & Group Triple P provides in‐depth parent education and skills training

through 10 sessions with a practitioner on an individual basis (Level 4 Standard) or 8 sessions

in a group with other families (Level 4 Group).

Level 5: Enhanced & Pathways Triple P offers additional support to help parents deal with

stress and improve communication with their partners or co‐parents (Level 5 Enhanced) and

handle anger or other difficult emotions (Level 5 Pathways).

Beginning in late 2009, three local funders (First 5 Santa Cruz County, Health Services Agency, and

Human Services Department) established the Triple P system in partnership with other agencies that

serve children and families. The program has been implemented in stages, with the goal of making

parenting information and support widely available to families throughout Santa Cruz County.

The Triple P program is available in Santa Cruz County for:

Families with children from birth – 12 years old (Core Triple P)

Families with teens 13 – 16 years old (Teen Triple P)

Families with children who have special needs (Stepping Stones Triple P)

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRONG FAMILIES – TRIPLE P


Snapshot of 2012‐13 Triple P Implementation and Results in Santa Cruz County

Level 1: Universal – Social Marketing Campaign

Branding & Messaging: Unified the branding and messaging for Triple P Santa Cruz County

Web site: 300 online registrations for Triple P classes

Triple P Warmline/Email: 110 requests for Triple P services received

Parenting Pocket Guides: Developed and distributed nearly 20,000 bilingual Triple P Pocket guides

Articles: Disseminated monthly articles with parenting tips in newspapers, web sites and Triple P Santa Cruz

County’s e-newsletter

Triple P Santa Cruz County Facebook Page: Gained 679 new fans; Increased interaction with fans

Advertisements and PSAs: in select newspapers, online calendars, TV and radio stations, Facebook

Videos: Created two PSAs in English & Spanish; Created promotional videos with parent testimonials in

English & Spanish; Shared via Triple P Santa Cruz County YouTube channel

Low Intensity

High Intensity

Level 2: Selected Individual & Seminar General information and tips for specific parenting concerns.

474 parents participated in Seminars; 206 parents received 1-time consultations

28 accredited practitioners were available to provide Seminars (19 Core, 9 Teen)

88 accredited practitioners were available to provide Level 2 Individual sessions (1-time consultations)

Parents report high levels of satisfaction with Seminars

Level 3: Primary Care Brief consultations and workshops about specific parenting concerns.

Families showed significant improvements in children’s behavior, confidence in parenting skills,

and support from parenting partners.

606 parents participated in Workshops; 70 parents received brief support though individual or

group sessions

88 accredited practitioners were available to provide Level 3 Primary Care services (80 Core, 5

Teen, 3 Stepping Stones)

Parents reported high levels of satisfaction with these brief services

Level 4: Standard (Individual) & Group In‐depth training in positive parenting skills.

Families reported significant improvements in parenting style, child behavior,

emotional well-being and reduced conflict

Parents who had more serious parenting issues made the most meaningful changes in

their family life

383 parents received Level 4 Individual & Group services

73 accredited practitioners were available to provide Level 4 services (42 Core, 18

Teen, 13 Stepping Stones)

Parents reported high levels of satisfaction with these services

Level 5: Enhanced & Pathways Additional support for families

2 parents received Level 5 Pathways services

18 accredited practitioners were available to provide Level 5 Enhanced, and

21 for Level 5 Pathways

EXTENT OF REA

CH IN

TO THE COMMUNITY

Broad Reach

Limited, Targeted Reach

INTENSITY

OF SERVICES



Triple P Highlights

Triple P’s population‐based approach to parenting support provides the minimally sufficient level of

care for parents to enable them to independently manage their family issues. This section provides

an overview of how families in Santa Cruz County have been helped to receive the levels of support

that they needed through their participation in Triple P, and highlights some of the key

achievements in each of these levels.

Level 1: Universal

Activities and media strategies for Level 1 of Triple P are providing access to positive parenting

information and destigmatizing the need to get help for parenting issues. In 2012‐13, First 5

implemented a robust social marketing campaign that included monthly parenting articles published

in Growing Up in Santa Cruz, Santa Cruz Parent, the Register‐Pajaronian and local Patches; video and

radio PSAs in English and Spanish; flyers promoting Triple P classes (Seminars, Workshops, Groups);

regular posts on the Triple P Santa Cruz County Facebook page; distribution of a bilingual Parenting

Pocket Guide; a monthly e‐newsletter; and promotion of First 5 as a hub for information and

assistance with accessing Triple P services.

Accessibility of information. Families are responding to Triple P messages in the media and

online. They are using the updated website to register for parenting classes and requesting

assistance with accessing Triple P services through the centralized “warmline” and Triple P email

address.

Encouragement to participate. Since the beginning of the Triple P program, approximately

4,324 parents and 7,714 children have participated in Triple P services. Although these figures

may include duplicate counts of parents who participated in multiple services, it reflects the

widespread interest in—and reach of—this parenting program.

Client Participation in Triple P

Source: Triple P Master Client Data Collection Template, 2013 (analyzed by First 5 and Applied Survey Research).

THIS FUNDING CYCLE

2012‐2013

CUMULATIVE TOTALS

2010‐2013

Parents/Guardians 1,666 4,324

Children (all ages) 2,927 7,714



Satisfaction with services. On average, parents rated the quality of services very high, noting

that they had received the help they wanted, were dealing more effectively with problems in

their family, and would come back to the program if they needed to seek help again.

Parents’ Satisfaction with Various Aspects of the Triple P Program

Source: Triple P data from the Parent Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013.

Level 2: Selected (Individual & Seminars) & Level 3: Primary Care (Workshops)

The briefest forms of Triple P services are giving parents an opportunity to be introduced to Triple P

and providing easy access to general parenting support.

Gateway to more services. Of parents who participated in Seminars and Workshops, 22%

requested follow‐up services, suggesting that these brief services may be an effective way of

getting parents initially engaged in the program, and gives them an opportunity to participate in

further services.

Parents who receive a Level 2 Individual consultation on a specific parenting topic are likely to

later participate in a Level 3 Individual/Brief Group program or a Level 4 Standard program. This

suggests that clients who begin with one or two brief sessions to get general information and

tips for specific parenting concerns are then interested in returning for more in‐depth

consultations and multi‐session programs.

Continued use of the skills they learned. On average, parents felt that the Seminars answered

their questions, and that they would continue to use the strategies they learned.

Seminar/Workshop Satisfaction Survey

Source: Triple P data from the Seminar/Workshop Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: All items were on a 5‐point scale. Higher scores indicate greater satisfaction.

6.07

6.26

6.36

6.36

6.43

6.44

1 2 3 4 5 6 7

13. How would you describe your feelings at this point aboutyour child's progress? (N=607)





1. How would you rate the quality of the service you and yourchild received? (N=622)

4.70

4.53

1 2 3 4 5

I am likely to use some of the parenting strategies inthe tip sheet. (N=2,125)

The seminar/workshop answered a question orconcern I have had about parenting. (N=2,125)

Highest Satisfaction

Lowest Satisfaction



Level 3: Primary Care (Individual or Brief Group)

Brief consultations about specific parenting concerns are resulting in increased positive parenting

experiences.

Support for specific parenting challenges. Parents are reporting increased confidence in

parenting, more support from their partners, less difficulty with their children’s behavior, and

increased enjoyment in their parent/child relationship.

Increases in Positive Parenting

Source: Triple P data from the Parenting Experience Survey, Questions 3, 6, 1, and 2, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parenting Experience Survey measures issues related to being a parent, and each question is analyzed separately. For Q1‐6, scores range from 1 to 5. For Q7, scores range from 0 to 6. Higher scores indicate more positive parenting experiences. There are no clinical cut‐offs for this assessment. The analysis of question 6 (Support from Partner in Their Role as a Parent) includes data from parents in Levels 3, 4, and 5, as this question was expanded to all of these levels of service in 2011‐12. * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Level 4: Standard & Group

Through more intensive services, families are receiving in‐depth support for moderate to severe

behavioral and emotional difficulties.

Intensive services may have a stronger impact on parents who begin the program with more

serious parenting issues. One new study evaluated the percentage of parents who

demonstrated improvement in one or more of the following key parenting domains: Perception

of child’s behavior; Overall parenting style; Depression; Anxiety; and Stress. The majority of All

Parents demonstrated improvement in all domains, but parents whose pre‐assessment scores

were high enough to be in a “Clinical Range of Concern” were even more likely to show

improvement by the end of the program, suggesting that Triple P was effective for parents who

had more serious parenting issues.

Percentage of Parents Who Demonstrated Improvement in One or More Key Parenting Domain (2010‐2013)

Source: Triple P assessment results (analyzed by Applied Survey Research), 2013. (Child behavior) ECBI, Problem subscale; (Style) Parenting Scale, Overall score ; (Depression) DASS‐21,Depression subscale; (Anxiety) DASS‐21, Anxiety subscale; (Stress) DASS‐21, Stress subscale.

N: (Child behavior) All=417, Clinical=200; (Style) All=490, Clinical=110; (Depression) All=526, Clinical=139; (Anxiety) All=526, Clinical=179; (Stress) All=525, Clinical=135.

3.3 3.5 3.23.7

4.2 3.9 4.0 4.1

012345

Confidence in ParentalResponsibilities** (N=121)

Support from Partner in theirRole As a Parent* (N=241)

Reduction in Difficulty of Child'sBehavior** (N=117)

Positivity of ParentingExperience** (N=112)

Pre Post

64.0%76.4%

54.1% 51.5%60.9%

88.0% 81.8% 84.2% 84.9% 89.6%

0%20%40%60%80%

100%

Perception of child'sbehavior

Overall parentingstyle

Depression Anxiety Stress

All Parents Clinical Range at Pre‐test

Extremely

Not at all

Higher is “Better”



Parents with adolescents are among those experiencing more serious parenting issues and

benefitting from Triple P. While the majority of parents who received in‐depth services were in

Core Triple P (targeting families with children ages 0‐12), a small number of parents completed

Teen Triple P (targeting families with youth ages 13‐16). Parents in Teen Triple P tended to

report more serious parenting issues than parents in Core Triple P, particularly in the areas of

parenting styles, number of problems with their partners over parenting, and their level of

depression, anxiety, and stress. Although parents in both Core and Teen Triple P showed

significant improvement in their parenting issues, parents in Teen Triple P demonstrated a

greater degree of improvement by the end of the program.

Improvements in Selected Parenting Issues—Comparison of Clients in Core and Teen Triple P (2010‐2013)

Number of problems with their partners over parenting

Depression

Source: Triple P data from the Depression, Anxiety, and Stress Scale – Short Version (DASS‐21) and the Parent Problem Checklist, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parent Problem Checklist measures the number of issues that have been a PROBLEM for parents. Scores for the PROBLEM subscale range from 0 (no issues were a problem) to 16 (all issues were a problem). The Depression, Anxiety, and Stress Scale – Short Version (DASS‐21) measures distress along 3 scales: Depression, Anxiety, Stress. Scores for each scale are calculated by summing the participants’ responses for each of the 21 items. Higher scores on each of the scales indicate greater levels of depression, anxiety, and stress. Each scale has different clinical cut‐offs for the 5 severity levels: normal, mild, moderate, severe, and extremely severe. * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

5.87.1

3.5 3.10

4

8

12

16

Core**(N=310)

Teen**(N=13)

Pre Post

9.513.6

6.2 7.7

0

7

14

21

28

35

42

Core*(N=503)

Teen**(N=19)

Pre Post

Lower is

“Better” Clinical Cut‐Off:

>5

No issues were a problem

All issues were a problem

Extremely severe distress

No distress

Clinical Cut‐offs:

Very Severe >=28

Severe >= 21

Moderate >=14

Lower is

“Better”



Increased use of positive parenting styles. There were significant improvements in parenting

styles, indicating parents became less lax, less over‐reactive, and less hostile though the course of

the Triple P program. Parents with more serious parenting issues made the greatest amounts of

improvement.

Parents’ Use of Positive Parenting Styles

Source: Triple P data from the Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parenting Scale measures parenting styles in 3 scales, and overall. Scores for each scale are calculated by averaging the participants’ responses for each of the items. Higher scores indicate a greater degree of ineffective parenting styles. In 2012, modifications were made to the Parenting Scale to accommodate the launching of the “Teen” variant of the Triple P program, so comparisons to previous years’ results should be made with caution. Due to these changes, there is no Clinical Cut‐Off for the overall assessment score. See Appendix C for a complete description of these changes. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Reduced levels of conflict over parenting. After completing the program, parents on average

indicated that there were significantly fewer parenting and relationship issues that were problems.

Parents in each of these populations tended to score above the clinical cut‐off at the beginning of

the program, and ended the program out of a range of concern. Again, on average, effect sizes

were much higher for parents in the Clinical Range at Pre‐test, suggesting that these intensive

services have a stronger impact on parents who begin the program with more serious parenting

issues.

Number of Parenting Issues That Have Been a Source of Conflict Between Parents

Source: Triple P data from the Parent Problem Checklist, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parent Problem Checklist measures the number of issues that have been a PROBLEM for parents. Scores for the PROBLEM subscale range from 0 (no issues were a problem) to 16 (all issues were a problem). * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

3.2 3.2 3.2 3.43.0

3.53.1 3.1

2.6 2.7 2.6 2.82.4

2.92.5 2.7

1

2

3

4

5

6

7


Male**(N=142)

Female**(N=348)

Latino**(N=273)

Caucasian**(N=171)

Spanish**(N=178)

English**(N=295)

Child WelfareInvolved*(N=132)

Pre Post

5.9

8.9

5.4 6.1 6.1 5.7 6.4 5.7 5.43.5 5.0 3.3 3.5 3.6 3.6 3.7 3.4 3.7

0

4

8

12

16

AllParents**(N=323)


Male**(N=122)

Female**(N=201)

Latino**(N=181)

Caucasian**(N=112)

Spanish**(N=116)

English**(N=196)


Pre Post


Lower is

“Better”


No issues were a problem

Clinical Cut‐Off:

>5

Lower is

“Better”

All issues were a problem



Increased levels of satisfaction with their relationship. As seen in the figure below, parents

reported improved satisfaction in the relationship with their partners. On average, for All

Parents and all analyzed sub‐populations there was significant improvement in how happy they

were with their relationship by the end of the program.

Level of Parents’ Satisfaction with Their Relationship

Source: Triple P data from the Parenting Experience Survey, Question 7, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parenting Experience Survey measures issues related to being a parent. Each question is analyzed separately, under the corresponding domain in this Triple P analysis. For Q1‐6, scores range from 1 to 5. For Q7, scores range from 0 to 6. Higher scores indicate more positive parenting experiences. There are no clinical cut‐offs for this assessment. The analysis of Question 7 (Level of Happiness in Relationship with Partner) includes data from parents in Levels 3, 4, and 5. * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05.

An analysis of Satisfaction Surveys showed that clients’ satisfaction with their partner was

slightly—but significantly—more likely to be improved by the end of the Triple P program, if

they had attended the program with another adult.

Percentage of Parents Whose Satisfaction with Their Partner Improved, by Type of Participation (2010‐2013)

Source: Triple P Master Client Data Collection Template, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013.

Notes:

Chi‐Square results were significant: Χ2(1, N = 1,013) = 6.41, p = .011.

Relationships were defined as having improved if the parent answered 5, 6, or 7 (on the 7‐point scale) to question 8 of the Satisfaction Survey.

Increased levels of emotional well‐being. The following figures indicate that on average, All

Parents and all sub‐populations significantly lowered their level of depression, anxiety, and

stress. The amount of change was much higher for parents with scores in the Clinical Range at

Pre‐test. This was the only sub‐population that began within the Severe range, and ended out of

a range of concern.

3.4 3.5 3.3 3.4 3.53.2

3.8 4.03.7 3.9 4.0

3.7

0

1

2

3

4

5

6

All Parents*(N=243)

Male*(N=73)

Female*(N=170)

Latino*(N=171)

Spanish*(N=125)

English*(N=112)

Pre Post

28.3%35.8%

0%

20%

40%

60%

80%

100%

Participated alone Participated with another adult

Perfect

Extremely unhappy




Level of Parental Depression and Stress

Depression

Anxiety

Stress

Source: Triple P data from the Depression, Anxiety, and Stress Scale – Short Version (DASS‐21), analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Depression, Anxiety, and Stress Scale – Short Version (DASS‐21) measures distress along 3 scales: Depression, Anxiety, Stress. Scores for each scale are calculated by summing the participants’ responses for each of the 21 items. Higher scores on each of the scales indicate greater levels of depression, anxiety, and stress. Each scale has different clinical cut‐offs for the 5 severity levels: normal, mild, moderate, severe, and extremely severe. * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

9.6

24.3

8.2 10.3 10.4 8.611.8

8.4 9.06.2

11.7

6.5 6.1 6.7 5.7 7.1 5.6 7.10

7

14

21

28

35

42

All Parents*(N=526)


Male*(N=159)

Female*(N=367)

Latino*(N=295)

Caucasian*(N=181)

Spanish*(N=187)

English*(N=321)


Pre Post

8.2

19.3

7.08.8

9.1 6.610.4 6.9 8.3

5.3 9.85.1 5.4 5.6 4.9 6.1 4.7 6.0

0

7

14

21

28

35

42

All Parents*(N=526)


Male*(N=159)

Female*(N=367)

Latino*(N=295)

Caucasian*(N=181)

Spanish*(N=187)

English*(N=321)


Pre Post

13.4

27.9

11.3 14.3 13.313.6 14.0 13.1 12.0

8.9

13.5

8.5 9.1 8.5 9.7 8.8 8.9 8.8

0

7

14

21

28

35

42

All Parents*(N=525)


Male*(N=159)

Female*(N=366)

Latino*(N=294)

Caucasian*(N=181)

Spanish*(N=186)

English*(N=321)


Pre Post


No distress


Very Severe >=28

Severe >= 21

Moderate >=14


No distress


Very Severe >=20

Severe >=15

Moderate >=10


No distress


Very Severe >=34

Severe >=26

Moderate >=19

Lower is

“Better”

Lower is

“Better”

Lower is

“Better”



Improvements in child behavior. For All Parents and all sub‐populations, there was a significant

reduction in the number of child behaviors that were perceived to be a problem. Of special note,

certain sub‐populations of parents scored above the clinical cut‐off at the beginning of the

program, and subsequently ended out of a range of concern by the end of the program. These

sub‐populations included parents with scores in the Clinical Range at Pre‐test, Female, Latino,

and Spanish‐speaking parents.


Source: Triple P data from the Eyberg Child Behavior Inventory, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Eyberg Child Behavior Inventory measures the frequency with which certain child behaviors occur (Intensity subscale), and whether parents view those behaviors to be a problem (Problem subscale). Intensity scores could range from 36 (Never occurs) to 252 (Always occurs), and Problem scores ranged from 0 (No) to 36 (Yes), with higher scores indicating greater numbers of problem behaviors and greater likelihood that these behaviors were a problem to the parent. * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Level 5: Enhanced & Pathways

Level 5 offers additional support for families where parenting issues are compounded by parental

stress and/or relationship difficulties (Level 5 Enhanced), or there is risk for child maltreatment due

to parents’ anger management issues or negative beliefs about their children’s behaviors (Level 5

Pathways). Not enough participants have completed the Level 5 program to provide enough data for

analysis. This may be an indication that Level 4 intensive services are meeting families’ needs and

very few families require additional interventions.

14.5

22.7

11.5

15.7 15.712.8

16.612.9 9.5

7.911.9

6.68.4 8.4

7.79.3

6.9 6.60

6

12

18

24

30

36



Male**(N=117)

Female**(N=300)

Latino**(N=242)

Caucasian**(N=132)

Spanish**(N=164)

English**(N=239)


Pre PostAll behaviors were

a problem



Lower is

“Better”



Population Served

The total number of clients who participated in Triple P is comprised of three groups: clients who

participated in individual or group sessions AND who consented to have their assessment data

anonymously included in this evaluation (who consequently provided enough information to create

a Unique ID), those who participated in Seminars or Workshops where no names or personal

information were collected, and those who received Triple P services but did NOT consent to

participate in the evaluation of Triple P.

Source: Triple P Master Client Data Collection Template, 2013 (analyzed by First 5 and Applied Survey Research).

* Includes parents and children for whom enough personal information was collected to be able to create a Unique ID. This includes parents participating in Levels 2 (Individual), and parents and children participating in Levels 3 (Primary Care), 4, and 5. Parents may have participated in more than one Triple P service. Children with unknown birth dates are not included.

**Includes parents and children in all Triple P program levels where no names or personal information were collected (such as Seminars and Workshops), and the children of parents who participated in Level 2 Individual sessions (where only parents had personal information collected). Parents may have participated in more than one Triple P service. This parent category also included early childhood educators and adolescents in Juvenile Hall who may not have been parents at that time. As parents did not always report the number of children in their families, and since early childhood educators estimated the number of children in their care, the total number of children reported here should be considered a close approximation of the number of children served in this category.

*** These totals include clients who may have participated in more than one Triple P service.

This Funding Cycle

2012‐2013

Cumulative Totals

2010‐2013

Clients Participating in Individual or Group Sessions – Unique IDs Created*

Parents/Guardians 561 1,503

AGES 0 – 5

AGES 6 – 12

AGES 13 – 16

AGES 17+

AGES 0 – 5

AGES 6 – 12

AGES 13 – 16

AGES 17+

Children 339 278 92 54 763 881 675 186 98 1,840

Clients Participating in Seminars & Workshops – No IDs**



Clients Participating in Individual or Group Sessions – Did Not Consent to Participate in Evaluation

Parents/Guardians 25 110

Children (all ages) 37 176

TOTAL*** TOTAL***





Participant Details

Figure 60: Demographics of Triple P Parents/Guardians (2010-2013)

Gender

Language Ethnicity

Source: SUN database/CCD data for July 1, 2010 – June 30, 2013 & Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research).

Note: Demographics are based on parents participating in Levels 3 Individual/Brief Group, 4, and 5 only. Percentages include unique (unduplicated) clients. Language refers to the language used to conduct the Triple P services.

N; (Gender)=1,473; (Ethnicity)= 1,365; (Language)= 1,480.

When parents filled out their assessments, they were asked to choose one child in their family

(“Index Child”), whose behaviors they were most concerned about or had the most difficulty

handling, and complete the assessments keeping just that one child in mind. Over half (53%) of

Index Children were between 0‐5 years of age, 38% were between ages 6‐12, and 8% were

ages 13‐16.

Figure 61: Ages of Children Chosen as the “Index” Child (2010-2013)

Source: Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research).

Note: Percentages represent ages of these Index children, after any duplicates have been removed. Levels 3 (Individual or Brief Group), 4, and 5 participants only.

N=880.

0%

20%

40%

60%

80%

100%

73.4%

26.6% Male

Female

0%

20%

40%

60%

80%

100%

49.9%

50.1%English

Spanish

0%

20%

40%

60%

80%

100%

70.0%

24.1%

5.9%Other

White/Caucasian

Latino/Hispanic

53.4%37.5%

7.7%1.4%

Ages 0‐5

Ages 6‐12

Ages 13‐16

Ages 17+



Program Participation

The following chart shows the types of Triple services that have been provided to participants since

the commencement of the program (2010‐13).

Figure 62: Types of Triple P Services Provided

Percentage of each Type of Service (2010‐2013)

Source: SUN database/CCD data for July 1, 2010 – June 30, 2012 & Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research).

Notes: Percentages include clients who may have participated in multiple services, and clients who did not consent to have their assessment data included in this evaluation, if their service type was known (due to reporting issues, non‐consenters participating in Level 4 Group and Standard are combined and reported under Level 4 Standard). N=4,558.

Number of Services Provided (by Type and Year)

Source: SUN database/CCD data for July 1, 2010 – June 30, 2013 & Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research). Notes: Percentages include clients who may have participated in multiple services, and clients who did not consent to have their assessment data included in this evaluation, if their service type was known. N: (2010‐11) N=907; (2011‐12) N=2,011; (2012‐13) N=1,741.

19.3%

11.8%

40.2%

4.8%

12.0%

11.7%0.1%

Level 2 Seminar

Level 2 Individual

Level 3 Workshop

Level 3 Individual/Brief Group

Level 4 Standard

Level 4 Group

Level 5 Pathways

0

500

1,000

1,500

2,000

2,500

2010‐11 2011‐12 2012‐13

96310

474117

334206

336

889606

41

103

70

317

372

383

3

2

907

2,011

1,741 Total

Level 5 Pathways

Level 4 (Standard/Group)


Level 3 Workshop

Level 2 Individual

Level 2 Seminar



Details of Program Participation

Program Outreach

Parents participating in Levels 3 (Individual or Brief Group), 4, or 5 were asked some basic

information about their involvement in Triple P, including where they had first heard about Triple P

and if they were participating with another adult. Parents participating in Level 2 Seminars and Level

3 Workshops were also asked where they had first heard about that service. Results for these client

details since the commencement of Triple P services (2010‐13) are presented below.

The top three ways that parents heard about Triple P were: Referred by an agency (38%),

Media / Advertisement (12%), or Friend or relative (10%).

Figure 63: How Participants First Heard about Triple P (2010-2013)

Source: Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research). Note: Percentages include clients who may have participated in multiple services. Beginning in 2012‐13, parents participating in Level 2 Seminars and Level 3 Workshops were also included in this analysis. N=975 respondents with 1,006 responses.

Service Path Analysis

Triple P Seminars and Workshops are intended to be a family‐friendly entry into the Triple P

system of services. Data indicate that 22% of participants request follow‐up services after

attending a Seminar or Workshop. This suggests that these brief Triple P classes are an effective

way of giving participants a chance to try out the Triple P program, getting them interested, and

giving them an opportunity to participate in further services.

Parents who participate in all other Triple P services (aside from Seminars and Workshops) are

asked to provide enough information to allow the creation of a “Unique ID” for each client. This

Unique ID enables First 5 to analyze patterns of program usage, including types and dosage of

services utilized. The following chart shows the number of parents (with Unique IDs) who

participated in one or more type of Triple P service.

38.2%

12.4%10.3%

9.0%

6.4%

5.1%

4.7%

3.8%10.1%

Referred by an agency

Media / Advertisement

Friend or relative

Court or CPS

School

Child care or preschool provider

Counselor or social worker

Doctor's office

Other



Figure 64: Number of Parents (with Unique IDs) Who Participated in One or More Type of Triple P Service (2010-2013)

NUMBER OF SERVICES RECEIVED NUMBER OF

PARENTS PERCENTAGE OF

PARENTS

1 Service 1,368 91.0%

2 Services1 130 8.6%

3 Services 5 0.3%

Total 1,503 100%2 Source: Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research).

Note: This analysis only includes clients who participated in Triple P services that collected enough information to create a Unique ID (Level 2 Individual, Level 3 Individual/Brief Group, Level 4, and Level 5), thereby allowing for clients to be tracked across multiple services. Therefore, this analysis does not include clients who participated in Level 2 Seminars or Level 3 Workshops. 1 Of the 130 clients who participated in two levels of service, 122 participated in them consecutively, and 13 participated in them simultaneously. 2 Percentages may not sum to 100% due to rounding.

Results show that 9% of these clients (with Unique IDs) participated in multiple types of Triple P

services, and there was interest in analyzing the “paths” that clients took through these different

levels of service, to see if some service levels were more likely to lead to engagement in other

service levels. The following table shows a matrix of the number of clients who started with each

level of service (“First Service”), and who then later participated in a second level of service

(“Second Service”). Results show that:

o Of the 122 clients who participated in two Triple P services consecutively, the most

common “service pathway” was among those who began with a Level 4 Group program.

These clients were most likely to later participate in a Level 2 Individual consultation (50

clients) or a Level 4 Standard program (10 parents).

This result suggests that clients who begin in a group program level that requires a high

level of commitment and time continue to feel engaged and are interested in continuing

their participation, either returning for a quick lesson on a specific topic, or to continue

with this more in‐depth parent education and skills training, on an individual level.

o The next most frequent “service pathway” was among those who began with a Level 2

Individual program. These clients were most likely to later participate in a Level 3

Individual/Brief Group program (11 clients) or a Level 4 Standard program (10 parents).

This result suggests that clients who begin with one or two brief sessions to get general

information and tips for specific parenting concerns, are then interested in returning for

more in‐depth consultations and multi‐session programs.



Figure 65: Matrix of Parents (with Unique IDs) Who Participated in Multiple Types of Services (2010-2013)

SECOND SERVICE

FIRST SERVICE

LEVEL 2 INDIVIDUAL

LEVEL 3 INDIVIDUAL / BRIEF GROUP

LEVEL 4 STANDARD

LEVEL 4 GROUP LEVEL 5

PATHWAYS

Level 2 Individual 0 11 10 5 0

Level 3 Individual/Brief Group 4 0 7 1 0

Level 4 Standard 9 2 0 6 2

Level 4 Group 50 2 10 0 2

Level 5 Pathways 1 0 0 0 0 Source: Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research).

Note: This analysis only includes clients who participated in Triple P services that collected enough information to create a Unique ID (Level 2 Individual, Level 3 Individual/Brief Group, Level 4, and Level 5), thereby allowing for clients to be tracked across multiple services. Therefore, this analysis does not include clients who participated in Level 2 Seminars or Level 3 Workshops. This analysis presents the data for the 122 clients who began one service before starting another (consecutive). 13 clients began multiple services on the same day (simultaneous), with no pattern yet emerging.

N=122.

Unfortunately this analysis could not include two of the most popular program levels (Level 2

Seminars and Level 3 Workshops), since these more informal levels do not collect enough

information from clients to allow the creation of “Unique IDs,” which would make it possible to

track these clients across multiple services. It is theorized that these two levels provide new

clients with an easy introduction to Triple P services, and also provide quick, continuing support

on specific topics to existing clients. Future studies may clarify how these two types of services fit

into clients’ Triple P pathways.

Service Completion Rates

An analysis of the percentage of parents who have completed their programs demonstrates the high

degree of clients’ commitment. Parents are considered to have completed their program after they

attended all the required sessions.

Figure 66: Percentage of Parents Who Completed Their Multi-Session Triple P Services (2010-2013)

Source: Triple P Master Client Data Collection Template, 2013 (analyzed by Applied Survey Research). Note: Only parents who had sufficient time to have completed their services were included in this analysis. * Due to the low number of participants in this program level, results should be interpreted with caution. N: (Level 3)=184, (Level 4 Standard)=304, (Level 4 Group)=282, (Level 4 Unspecified)=257, (Level 5)=5, (Overall)=1,032.

73.4%

55.6%65.2% 64.6% 60.0% 63.7%

0%

20%

40%

60%

80%

100%

Level 3Individual /Brief Group

Level 4Standard

Level 4 Group Level 4(unspecified)

Level 5Pathways*

Overall



What Parents Are Saying

“I love it when I feel like I have learned necessary tools to help my baby grow.”

“It is important to have these workshops in our community. I wasn’t provided with this important information from my parents or schools.”

- Triple P Client Satisfaction Surveys

Satisfaction with Services

All parents in the Triple P program (except those attending brief Level 2 Individual sessions) were

asked to complete a self‐administered satisfaction survey upon completing their services.


Parents participating in Levels 3 (Individual or Brief Group)

and Levels 4 and 5 of the Triple P Program filled out a

Parent Satisfaction Survey with 13 questions using a 7‐point

scale (with 7 indicating highest satisfaction), and 3 open‐

ended questions.

o For each of the survey questions, the average parent

satisfaction rating ranged from 5.34 to 6.44, on the 7‐

point scale, indicating a high level of satisfaction with

various aspects of the program experience.

o Most parents felt the highest satisfaction with the quality of the service they and their

child received (6.44), and how the program helped them to deal more effectively with

their child's behavior (6.43). Although still very positive, parents reported the lowest level

of satisfaction with how the program improved their relationship with their partner (5.34),

which has consistently been the most difficult issue over the years.

Parents participating in the Level 2 Seminars and Level 3 Workshops filled out a shorter

Satisfaction Survey with 3 questions using a 5‐point scale (with 1=Disagree, and 5=Agree),

and 1 open‐ended question.

o Most parents felt that they would continue to use the tip sheets (4.70), that they were

very satisfied with the services they received (4.67), and that the program answered their

question or concern (4.53).



Figure 67: Parents’ Satisfaction with the Triple P Program: Levels 3 (Individual or Brief Group), and Levels 4 and 5 (2010-2013)

Source: Triple P data from the Parent Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: All items were on a 7‐point scale. Higher scores indicate greater satisfaction.

Figure 68: Parents’ Satisfaction with the Triple P Seminars/Workshops (2010-2013)

Source: Triple P data from the Seminar/Workshop Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013.

Note: All items were on a 5‐point scale. Higher scores indicate greater satisfaction.

6.07

6.00

6.26

6.36

6.29

5.34

6.36

6.43

5.96

6.03

5.79

6.30

6.44

1 2 3 4 5 6 7

13. How would you describe your feelings at this point aboutyour child's progress? (N=607)

12. In your opinion, how is your child's behavior at this point?(N=608)



9. In an overall sense, how satisfied are you with the program youand your child received? (N=607)

8. Do you think your relationship with your partner has beenimproved by the program? (N=533)



5. How satisfied were you with the amount of help you and yourchild received? (N=618)

4. To what extent has the program met your needs? (N=620)

3. To what extent has the program met your child's needs?(N=617)

2. Did you receive the type of help you wanted from theprogram? (N=619)

1. How would you rate the quality of the service you and yourchild received? (N=622)

4.67

4.70

4.53

1 2 3 4 5

3. Overall I was satisfied with the workshop. (N=2,125)

2. I am likely to use some of the parenting strategies in the tipsheet. (N=2,125)

1. The seminar/workshop answered a question or concern I havehad about parenting. (N=2,125)

Highest Satisfaction

Lowest Satisfaction

Agree

Disagree



Building a Population‐Based System of Parent Education

Triple P Practitioners

First 5 Santa Cruz County began training agencies and independent practitioners to provide Triple P

services to clients in late 2009. Some agencies are specifically funded by First 5 Santa Cruz County to

provide Triple P services, others incorporate Triple P into their existing list of services, and some

independent practitioners offer Triple P on a fee‐for‐service basis. The following table lists the

number and types of agencies and organizations in Santa Cruz County that had accredited Triple P

practitioners as of 2012‐13.

Figure 69: Number and Types of Organizations with Accredited Triple P Practitioners, by Triple P Level (2012-2013)

LEVELS 2 & 3 LEVELS 4 & 5

TYPE OF ORGANIZATION NUMBER TYPE OF ORGANIZATION NUMBER

Health care 6 Private practitioner/therapist 8

Private practitioner/therapist 8 Counseling 4

Family Resource Center 3 Family Resource Center 3

Early childhood education 2 Special Education 2

Counseling 2 Early Childhood Education 1

County Child Welfare 1 First 5 1

County Mental Health 1 County Mental Health 1

Domestic violence 1 County Probation 1

First 5 1 Differential response 1

Number of Organizations 25 Number of Organizations 22 Source: Optimal Solutions Consulting, 2013.

Agency staff and independent practitioners attended workshops to become trained and accredited

practitioners of the Triple P Program, and many of these practitioners were trained in multiple

levels. Since 2009, a total of 118 practitioners have been accredited to provide Triple P services.

Figure 70: Number of Accredited Triple P Practitioners

COURSE TYPE

ACCREDITED DURING THIS FUNDING CYCLE

2012‐2013

CUMULATIVE TOTALS

2009‐2013

Level 2 Seminars Core (0‐12) 0 19

Teen (13‐16) 9 9

Level 3 Primary Care* Core (0‐12) 3 80

Teen (13‐16) 5 5

Stepping Stones 3 3



COURSE TYPE

ACCREDITED DURING THIS FUNDING CYCLE

2012‐2013

CUMULATIVE TOTALS

2009‐2013

Level 4 Group Core (0‐12) 1 37

Teen (13‐16) 0 18

Level 4 Standard Core (0‐12) 4 42

Teen (13‐16) 0 18

Stepping Stones 0 13

Level 5 Enhanced 0 18

Level 5 Pathways 0 21

Total Number of Practitioners (unduplicated)

19 118

Source: Optimal Solutions Consulting, 2013. * Level 3 Primary Care includes Workshops and Individual/Brief Group services.

Alignment of referral, billing, and data sharing processes across the network of agencies who support Triple P

Referral System

First 5 continued to serve as the central hub of the Triple P system for accredited practitioners,

organizations requesting information and referrals and community members seeking assistance

with accessing Triple P services. In 2012‐13, First 5 implemented the following steps to enhance the

Triple P system and facilitate family‐friendly access to services:

Refined First 5’s website to include updated information about Triple P, a searchable

directory of practitioners and a master calendar of Triple P classes with online registration

forms.

Produced flyers for practitioners to promote their Triple P classes.

Promoted Triple P services through online calendars, newspapers, PSAs, Facebook, television

interviews and a monthly e‐newsletter.

Distributed Triple P Parenting Pocket Guides at community outreach events and through

partner agencies.

Publicized First 5’s main phone number as a “warmline,” or central place to receive

assistance with accessing Triple P services.

Conducted presentations about Triple P and service options to interested groups and

organizations.



Billing and Funding

First 5, Health Services Agency (Children’s Mental Health), and the Human Services Department

continued their collaborative system for funding Triple P trainings, parent resources, and services.

Children’s Mental Health contracted with First 5 to implement Prevention and Early

Intervention strategies in the Mental Health Services Act (MHSA) Plan, including the

coordination and implementation of Triple P.

First 5 blended its own resources with funds from Children’s Mental Health to contract with

Triple P America and organizations providing specific Triple P services. This blended funding

strategy streamlined billing procedures and reporting requirements, which allowed resources

to be used in a more flexible and coordinated manner.

Agencies that were approved Medi‐Cal providers billed EPSDT for Triple P services.

Families in the Child Welfare System received services funded from a contract between the

Human Services Department (HSD) and the Parents Center.

Medical offices are beginning to explore billing health insurance for parent education.

Data Sharing

Practitioners are trained to obtain parents’ informed consent to participate in the evaluation of the

Triple P program, collect the required intake and assessment data, and submit the data to First 5 on

a monthly basis. Specific protocols have been established to protect the privacy and confidentiality

of parents participating in Triple P services. First 5 continued to proof all assessment data to ensure

completeness and accuracy and provided real‐time feedback to practitioners, which has been crucial

to ensuring the integrity of Triple P outcomes.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRONG FAMILIES – LA MANZANA COMMUNITY RESOURCES


La Manzana Community Resources

Program Description

First 5 funds La Manzana Community Resources (LMCR) to provide all levels of Triple P services

throughout the county to both English‐ and Spanish‐speaking participants. Funding from the Mental

Health Services Act for prevention and early intervention enables LMCR to serve families with

children of all ages, including children with special needs.

Population Served

2012‐2013(Participated in Triple P)

Clients Participating in Individual or Group Sessions – Unduplicated


AGES 0 – 5

AGES 6 – 12

AGES 13 – 16

AGES 17+

Children 157 146 46 24 373

Clients Participating in Seminars & Workshops – May include duplicates


Children (all ages) 1,201



Children (all ages) 13

TOTAL


Children (all ages) 1,587

Source: (Consenting clients ) SUN database/CCD data for July 1, 2012 – June 30, 2013; (Seminar & Workshop clients & Non‐Consenting clients) Triple P Master Client Data Collection Template, 2013.

Figure 71: Types of Triple P Services Provided (LMCR: 2012-13)


N=817.

16.5%

19.7%

37.8%

6.5%

8.7%

10.5%0.2%

Level 2 Seminar

Level 2 Individual

Level 3 Workshop


Level 4 Standard

Level 4 Group

Level 5 Pathways

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – LA MANZANA COMMUNITY RESOURCES


Improvements in Parenting

In the analyses of the following Triple P outcomes at LMCR, all the assessment data since the

commencement of the Triple P have been aggregated (January 2010 – June 2013) in order to

present a more robust portrait of the extent to which the Triple P participants at LMCR are

developing their parenting skills and knowledge.

Parents received support for specific parenting challenges

LMCR clients who completed Level 3 Individual/Brief Group of the Triple P program reported

increased confidence in parenting, more support from their partners, less difficulty with their

children’s behavior, and increased enjoyment in their parent/child relationship, as measured by the

Parenting Experience Survey.

Figure 72: Increases in Positive Parenting (LMCR: 2010-2013)

Source: Triple P data from the Parenting Experience Survey, Questions 3, 6, 1, and 2, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parenting Experience Survey measures issues related to being a parent, and each question is analyzed separately. For Q1‐6, scores range from 1 to 5. For Q7, scores range from 0 to 6. Higher scores indicate more positive parenting experiences. There are no clinical cut‐offs for this assessment. The analysis of question 6 (Support from Partner in Their Role as a Parent) includes data from parents in Levels 3, 4, and 5, as this question was expanded to all of these levels of service in 2011‐12. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Parents increased their use of positive parenting styles

LMCR clients who completed Levels 4 and 5 of the Triple P program reported an increase in their use

of positive parenting styles, as measured by the Parenting Scale.

On average, for All Parents and all analyzed sub‐populations, there was significant

improvement from pre to post assessment regarding parents’ overall style of discipline,

indicating their parenting style became less lax, less over‐reactive, and less hostile though the

course of the Triple P program.

An analysis of Effect Sizes showed that on average, All Parents and all analyzed parent sub‐

populations experienced a moderate to large magnitude of change. These results indicate

that these observed differences were not only statistically significant but also meaningful.

3.3 3.4 3.13.8

4.2 4.0 4.0 4.3

0

1

2

3

4

5

Confidence in ParentalResponsibilities** (N=89)

Support from Partner in theirRole As a Parent** (N=145)

Reduction in Difficulty of Child'sBehavior** (N=88)

Positivity of ParentingExperience** (N=86)

Pre PostExtremely

Not at all




Figure 73: Parents’ Use of Positive Parenting Styles (LMCR: 2010-2013)

Source: Triple P data from the Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parenting Scale measures parenting styles in 3 scales, and overall. Scores for each scale are calculated by averaging the participants’ responses for each of the items. Higher scores indicate a greater degree of ineffective parenting styles. In 2012, modifications were made to the Parenting Scale to accommodate the launching of the “Teen” variant of the Triple P program, so comparisons to previous years’ results should be made with caution. Due to these changes, there is no Clinical Cut‐Off for the Overall assessment score. See Appendix C for a complete description of these changes. Subpopulations with fewer than 10 clients were not analyzed. * Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Parents reported improved child behavior

After completing the Triple P Program, parents reported a decrease in the frequency and number of

problematic child behaviors, as measured by the Eyberg Child Behavior Inventory (ECBI).


On average, for All Parents and all sub‐populations, there was a significant reduction in how

often problematic child behaviors occurred.

On average, for All Parents and all sub‐populations, there was a significant reduction in the

number of child behaviors that were perceived to be a problem. On average, all parent

populations began with scores within the clinical range, and ended with scores that were out

of the clinical range.

An analysis of Effect Sizes showed that on average, All Parents and all parent sub‐populations

experienced a moderate to large magnitude of change. These results indicate that these

observed differences were not only statistically significant but also meaningful.

3.4 3.2 3.4 3.43.0

3.5 3.22.7 2.7 2.7 2.8

2.32.9

2.5

1

2

3

4

5

6

7


Male**(N=55)

Female**(N=174)

Latino**(N=179)

Caucasian**(N=32)

Spanish**(N=133)

English**(N=85)

Pre Post



Lower is

“Better”



Figure 74: Parents’ Perceptions of Child Behavior (LMCR: 2010-2013)




Note: The Eyberg Child Behavior Inventory measures the frequency with which certain child behaviors occur (Intensity subscale), and whether parents view those behaviors to be a problem (Problem subscale). Intensity scores could range from 36 (Never occurs) to 252 (Always occurs), and Problem scores ranged from 0 (No) to 36 (Yes), with higher scores indicating greater numbers of problem behaviors and greater likelihood that these behaviors were a problem to the parent.


124.8

165.7

118.1126.9 123.7 129.7 123.5 127.4

92.2

112.392.9 92.0 90.5

101.289.9 96.1

36

72

108

144

180

216

252


Clinical Rangeat PreTest**

(N=94)

Male**(N=52)

Female**(N=171)

Latino**(N=174)

Caucasian**(N=31)

Spanish**(N=131)

English**(N=82)

Pre Post

17.0

23.6

15.0 17.6 17.3 17.417.4 16.0

8.3 11.5

7.4 8.5 8.67.6

9.26.6

0

6

12

18

24

30

36


Clinical Rangeat PreTest**(N=124)

Male**(N=49)

Female**(N=161)

Latino**(N=168)

Caucasian**(N=25)

Spanish**(N=127)

English**(N=74)

Pre Post







Lower is

“Better”

Lower is

“Better”



Parents Reported High Satisfaction with Services

LMCR parents receiving Triple P services reported high levels of satisfaction with the program.


Parents participating in Levels 3 (Individual or Brief Group), 4, and 5 of the Triple P Program

reported average satisfaction ratings ranging from 5.58 to 6.54, on a 7‐point scale, indicating

a high level of satisfaction with various aspects of the program experience. Most parents felt

the highest satisfaction with how the program helped them to deal more effectively with

their child's behavior (6.54), and with the quality of the service they and their child received

(6.54).

The average parent satisfaction ratings for Level 3 Workshops ranged from 4.71 to 4.77, and

Level 2 Seminars ranged from 4.76 to 4.86, on the 5‐point scale. Virtually all parents felt that

the program answered their questions, that they would continue to use the tip sheets, and

were very satisfied with the services they received.

One client’s story:

“Sofia and Juan* came in looking for support for their two foster children who they were also seeking to adopt. They were concerned about the oldest, now 3 years old, who had temper tantrums. Due to the child’s traumatic past, the mother was afraid to hurt the child’s feelings by addressing his behavior.

We assured her that the strategies suggested in this course would not harm the child. We went over the Tantrums tip sheet and taught the parents simple strategies to prevent tantrums – quality time, praise, engaging activities – and strategies for handling tantrums when they occurred.

Mother was able to give some examples of when she would use these strategies. After putting these strategies in practice over the four weeks, the couple reported back that the child was doing much better in terms of asking for things instead of throwing tantrums. Mom is now able to better attend to the children with less stress and frustration.”

-LMCR, Annual Progress Report

(*All names have been changed)



Figure 75: Parents’ Satisfaction with Various Aspects of the Triple P Program (LMCR: 2010-2013)

Levels 3 (Individual or Brief Group), 4, and 5

Source: Triple P data from the Parent Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: All items were on a 7‐point scale. Higher scores indicate greater satisfaction.

Level 3 Workshops

Source: Triple P data from the Workshop Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013.


Level 2 Seminars

Source: Triple P data from the Seminar Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013.


N=192.

6.07

6.33

6.40

6.47

6.54

6.54

1 2 3 4 5 6 7


11. Has the program helped you to develop skills that can be appliedto other family members? (N=311)





4.77

4.77

4.71

1 2 3 4 5

3. Overall I was satisfied with the workshop. (N=763)

2. I am likely to use some of the parenting strategies in the tipsheet. (N=761)

1. The workshop answered a question or concern I have hadabout parenting. (N=761)

4.83

4.86

4.76

1 2 3 4 5

3. Overall I was satisfied with the seminar

2. I am likely to use some of the parenting strategies in the tipsheet.

1. The seminar answered a question or concern I have had aboutparenting.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRONG FAMILIES – MOUNTAIN COMMUNITY RESOURCES


Mountain Community Resources

Program Description

First 5 funds Mountain Community Resources (MCR) to provide all levels of Triple P services,

primarily in the San Lorenzo Valley and Scotts Valley communities, to both English‐ and Spanish‐

speaking participants. Funding from the Mental Health Services Act for prevention and early

intervention enables MCR to serve families with children of all ages, including children with special

needs.

Population Served

2012‐2013(Participated in Triple P)

Clients Participating in Individual or Group Sessions – Unique IDs Created*


AGES 0 – 5

AGES 6 – 12

AGES 13 – 16

AGES 17+

Children 22 22 10 3 57

Clients Participating in Seminars & Workshops – No IDs**




Parents/Guardians 1


TOTAL***



Source: (Consenting clients ) SUN database/CCD data for July 1, 2012 – June 30, 2013; (Seminar & Workshop clients & Non‐Consenting clients) Triple P Master Client Data Collection Template, 2013.

* Includes parents and children for whom enough personal information was collected to be able to create a Unique ID. This includes parents participating in Levels 2 (Individual), and parents and children participating in Levels 3 (Individual or Brief Group), 4, and 5. Parents may have participated in more than one Triple P service.

**Includes parents and children in all Triple P program levels where no names or personal information were collected (such as Seminars and Workshops), and the children of parents who participated in Level 2 Individual sessions (where only parents had personal information collected). Parents may have participated in more than one Triple P service. As parents did not always report the number of children in their families, the total number of children reported here should be considered a close approximation of the number of children served in this category.

*** These totals include clients who may have participated in more than one Triple P service.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – MOUNTAIN COMMUNITY RESOURCES


Figure 76: Types of Triple P Services Provided (MCR: 2012-13)


Notes: Percentages include clients who may have participated in multiple services, and clients who did not consent to have their assessment data included in this evaluation, if their service type was known (due to reporting issues, non‐consenters participating in Level 4 Group and Standard are combined and reported under Level 4 Standard). N=228.

Assessment Results

In the analyses of the following Triple P outcomes at MCR, all the assessment data since the

commencement of the Triple P have been aggregated (January 2010 – June 2013) in order to

present a more robust portrait of the extent to which the Triple P participants at MCR are

developing their parenting skills and knowledge.

The majority of MCR’s clients were female, Caucasian, and English‐speaking. Consequently, the

male, Latino, and Spanish‐speaking subpopulations do not yet have enough assessment data to

analyze.

Parents increased their use of positive parenting styles

MCR clients who completed Levels 4 and 5 of the Triple P program reported an increase in their use

of positive parenting styles, as measured by the Parenting Scale.


On average, for All Parents and sub‐populations with enough clients (Female, Caucasian,

English‐speaking), there was significant improvement from pre to post assessment regarding

parents’ overall style of discipline, indicating their parenting style became less lax, less over‐

reactive, and less hostile though the course of the Triple P program.

An analysis of Effect Sizes showed that on average, all significant results also exhibited a

moderate to large magnitude of change. These results indicate that these observed

differences were not only statistically significant but also meaningful.

45.6%

35.1%

16.2%

3.1%

Level 2 Seminar

Level 3 Workshop

Level 4 Standard

Level 4 Group



Figure 77: Parents’ Use of Positive Parenting Styles (MCR: 2010-2013)

Source: Triple P data from the Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: The Parenting Scale measures parenting styles in 3 scales, and overall. Scores for each scale are calculated by averaging the participants’ responses for each of the items. Higher scores indicate a greater degree of ineffective parenting styles. In 2012, modifications were made to the Parenting Scale to accommodate the launching of the “Teen” variant of the Triple P program, so comparisons to previous years’ results should be made with caution. Due to these changes, there is no Clinical Cut‐Off for the Overall assessment score. See Appendix C for a complete description of these changes. Subpopulations with fewer than 10 clients were not analyzed. ** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Parents reported improved child behavior

After completing the Triple P Program, parents reported a decrease in the frequency and number of

problematic child behaviors, as measured by the Eyberg Child Behavior Inventory (ECBI).


On average, for All Parents and sub‐populations with enough clients (Female, Caucasian,

English‐speaking), there was a significant reduction in how often problematic child behaviors

occurred. On average, these parent populations began with scores within the clinical range,

and ended with scores that were out of the clinical range.

On average, for All Parents and most sub‐populations with enough clients (Clinical Range at

Pre‐test, Female, Caucasian, English‐speaking), there was a significant reduction in the

number of child behaviors that were perceived to be a problem. On average, these parent

populations (except Females) began with scores within the clinical range, and ended with

scores that were out of the clinical range.

An analysis of Effect Sizes showed that on average, all significant results also exhibited a

moderate to large magnitude of change. These results indicate that these observed

differences were not only statistically significant but also meaningful.

3.1 3.1 3.1 3.1

2.3 2.3 2.2 2.31

2

3

4

5

6

7

All Parents**(N=18)

Female**(N=12)

Caucasian**(N=14)

English**(N=16)

Pre Post



Lower is

“Better”

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – MOUNTAIN COMMUNITY RESOURCES


Figure 78: Parents’ Perceptions of Child Behavior (MCR: 2010-2013)




Note: The Eyberg Child Behavior Inventory measures the frequency with which certain child behaviors occur (Intensity subscale), and whether parents view those behaviors to be a problem (Problem subscale). Intensity scores could range from 36 (Never occurs) to 252 (Always occurs), and Problem scores ranged from 0 (No) to 36 (Yes), with higher scores indicating greater numbers of problem behaviors and greater likelihood that these behaviors were a problem to the parent.


132.9 132.5 132.2 130.8109.3 109.4 108.3 109.3

36

72

108

144

180

216

252

All Parents**(N=18)

Female**(N=12)

Caucasian**(N=14)

English** (N=16)

Pre Post

15.4

18.8

13.7 15.8 15.410.9 12.510.6 11.1 11.4

0

6

12

18

24

30

36

All Parents**(N=17)

Clinical Range atPreTest**(N=12)

Female(N=11)

Caucasian**(N=14)

English**(N=16)

Pre Post

“A young couple came in for Level 4 parenting sessions after being referred by CPS. Mom reported that they were having difficulty with their 3-year-old child not doing as he was told. Mom’s Triple P pre-assessments showed severe anxiety and stress, and clinically high scores in over-reactivity. Dad denied that the child exhibited [any problems], [and said] he felt undermined when using [the parenting] tools he knew. Both parents had difficulty agreeing on tools to handle their very intelligent, verbal, and physically active child.

Both parents began to use the positive parenting tools together and followed through with logical consequences when their child tested them. Instead of always undermining each other with a different way to parent, they say they now agree to try their best to follow through and support each other.

Mom’s depression, anxiety, and stress scores have all dropped. She reports that the number of problems their son shows has dropped, and her parenting style is much less over-reactive. Dad now sees a few problems that the child exhibits, which is an improvement from the “perfection” he perceived before. He actively parents his child and participates with enthusiasm in positive parenting.”

- Mountain Community Resources, Annual Progress Report







Lower is

“Better”

Lower is

“Better”



Parents Reported High Satisfaction with Services

MCR parents receiving Triple P services reported high levels of satisfaction with the program.


Parents participating in Levels 3 (Individual or Brief Group), 4, and 5 of the Triple P Program

reported average parent satisfaction ratings ranging from 4.37 to 6.62, on a 7‐point scale,

indicating a high level of satisfaction with various aspects of the program experience. On

average, parents gave the highest rating to the question, “If you were to seek help again,

would you come back to this organization?” (6.62), closely followed by the quality of service

they and their child received (6.33).

The average parent satisfaction ratings for Level 3 Workshops ranged from 4.46 to 4.68, and

Level 2 Seminars ranged from 4.21 to 4.67, on the 5‐point scale. Virtually all parents felt that

the program answered their questions, that they would continue to use the tip sheets, and

were very satisfied with the services they received.

Figure 79: Parents’ Satisfaction with Various Aspects of the Triple P Program (MCR: 2010-2013)

Levels 3 (Individual or Brief Group), 4, and 5

Level 3 Workshops

Level 2 Seminars

Source: Triple P data from the Seminar Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 ‐ June 2013. Note: All items were on a 5‐point scale. Higher scores indicate greater satisfaction.

5.95

5.95

6.62

6.19

6.10

6.33

1 2 3 4 5 6 7


11. Has the program helped you to develop skills that can be appliedto other family members? (N=21)





4.64

4.68

4.46

1 2 3 4 5

3. Overall I was satisfied with the workshop. (N=223)


1. The workshop answered a question or concern I have hadabout parenting. (N=225)

4.45

4.67

4.21

1 2 3 4 5

3. Overall I was satisfied with the seminar. (N=168)


1. The seminar answered a question or concern I have had aboutparenting. (N=169)

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – SIDE‐BY‐SIDE


“Side By Side uses a holistic community-based approach to early childhood mental health that provides both clinical services and education and support for children, parents, and staff. Its unique relationship to child care centers and their staff ensures that children are provided with quality care and expertise when they are the most vulnerable.”

-Side-by-Side, Annual Progress Report

Side-by-Side

Program Description

The Side‐by‐Side: Early Childhood Mental Health Access Program, launched in March 2010, was

created to address the significant need for early mental health services for families with children

between 0‐5 years of age. The program has expanded early childhood mental health services within

state‐funded child care programs and provides intervention services to families who have children

showing early signs of social/emotional difficulty. The program also provides guidance and

consultation about social/emotional and mental health needs of infants and young children to early

childhood educators. The program strives to support

the working relationship between families and child

care providers/preschool staff.

Parents can elect to receive only “Site‐based”

services for their children (i.e., classroom

observations, in‐class intervention, and teacher

consultations) or a combination of “Site‐based” and

“Family services” (i.e., classroom observations, in‐

class intervention, teacher consultations, individual/family counseling, and assistance from the

Family Resource Specialist, if needed). Since the Ages & Stages Questionnaires (ASQ) and the Child

Behavior Checklist (CBCL) are completed by parents, only parents who are participating in “Family

services” fill out these assessments. For the children who are receiving “Site‐based” services only,

Side‐by‐Side Clinician/Consultants provide recommendations to teachers and additional follow‐up,

as needed.

Population Served

2012‐2013

Staff/Child Care Providers 40


Children 25

Source: (Parents/Guardians) Side by Side 2012‐13 Annual Progress Report; (Children) SUN database/CCD data for July 1, 2012 – June 30, 2013.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT STRONG FAMILIES – SIDE‐BY‐SIDE


Outcome Objective: Children participating in “Family Services” will receive developmental screening and be assessed for behavioral and emotional problems

2012‐2013

90% of all families receiving Family Services from the Side‐by‐Side Program will receive evidence‐based screenings by completing the ASQ and CBCL.

ASQ 87.5%

CBCL 91.7%

Source: Side by Side 2012‐13 Annual Progress Report.

Note: Results should be interpreted with caution due to the low number of cases.

N=24.

Outcome Objective: Families participating in “Family Services” will report improvements in child behavior

2012‐2013

1. 85% of eligible families completing between 8‐12 psychotherapy/counseling meetings will complete the Child Behavior Checklist (CBCL) as a pre‐intervention/post‐intervention measure.

91.7%

N=12

2. Of those completing both a pre and post CBCL, 75% will demonstrate improvement in at least one measure on the CBCL.

100%

N=11

Source: Side by Side 2012‐13 Annual Progress Report.

Note: Results should be interpreted with caution due to the low number of cases.

The results indicate that children are greatly benefiting from their participation in “Family Services.”

Almost 88% of these children completed developmental screenings, and of those whose parents

participated in 8‐12 psychotherapy/counseling meetings and completed pre/post assessments,

100% of families reported improvement in their children’s behavior.

As part of the family services, Side‐by‐Side Clinician/Consultants helped the child care providers

address behaviors of concern by providing education, guidance, support, and intervention

strategies. Even though child/family‐focused consultations were “individual” in nature, it was the

Clinician/Consultants’ intention that the providers be able to generalize what they learned to other

similar situations, and to use their understanding of psychological principles of early childhood

development to guide future decisions.

In program/system‐focused consultations, the Clinician/Consultants helped the staff improve the

overall quality of the classroom environment, and increase their responsiveness to the students. In

addition, the Clinician/Consultants assisted the staff to become better able to effectively intervene

with children’s social/emotional difficulties and programmatic problems that negatively impacted

the students, families, and staff. The primary goal of programmatic/systemic‐focused consultation

was to help the staff promote and support the social/emotional well‐being of the children, and

prevent the occurrence of challenging behaviors within the classroom.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – SIDE‐BY‐SIDE


Outcome Objective: Children participating in “Site-based” services will have their needs evaluated and addressed

For children who participated in “Site‐based” services only, Side‐by‐Side Clinician/Consultants

observed these children in their classroom settings, and had consultations with the child

care/pre‐school staff. The Clinician/Consultants individualized the services they provided, varying

the number of classroom observations and consultations depending on the needs of the child and

the staff.

In 2012‐13, clinicians reported two major themes among the teachers and staff being served by

Side‐by‐Side. First, teaching staff continued to report that the challenges of individualizing services

for specific children—and at the same time meeting the needs of the classroom as a whole—could

be overwhelming. Second, staff consistently requested support for the development of language

that assisted in “redirecting” children from disruptive activities, and were particularly interested in

self‐care and stress related activities.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ QUALITY EARLY LEARNING INITIATIVE


“A growing body of

research confirms the

importance of quality early

learning experiences to

effectively prepare young

children not only for school,

but for life.”

‐ First 5 California


Quality Early Learning Initiative

Program Description


collaboration with local partners, with the goal of improving the quality of early learning programs

in Santa Cruz County. First 5 established this initiative as a result of funding received through

California’s Race to the Top ‐ Early Learning Challenge (RTT‐ELC) federal grant and First 5 California’s

Child Signature Program (CSP). Both of these grants share a common goal of increasing the quality

of early learning programs and closing the achievement gap for vulnerable young children, and are

described below.

Race to the Top – Early Learning Challenge

In 2012, California received a highly competitive Race to the Top ‐ Early Learning Challenge (RTT‐

ELC) federal grant to improve the quality of early learning programs and close the achievement gap

for vulnerable young children. Santa Cruz County is one of the 16 California counties included in this

4‐year grant. During this time, California—led by local efforts in the 16 counties in collaboration with

the California Department of Education—will work together to ensure positive outcomes for infants,

toddlers, and preschoolers. The end goal of California’s RTT‐ELC effort is that young children—

particularly those who are low‐income, English learners, or children with

disabilities or developmental delays—have access to high quality early

learning programs so that they thrive in their early learning settings and

succeed in kindergarten and beyond. The state will use the funding

primarily to build and pilot a new child care rating system—called the

Quality Rating and Improvement System (QRIS)—to collect and

disseminate information about the quality of early learning programs.

The process of building a QRIS ultimately will result in:

A shared definition of child care quality based on reliable and

validated research

A comprehensive and consistent approach to assess quality

A design to evaluate the rating system and its impact

Access to a system that supports quality improvement, especially for programs serving

children with high needs (low income children, infants, dual language learners, children with

special needs)

A consistent way for providers to communicate to parents and caregivers about quality

Increased consumer awareness about—and demand for—high quality child care

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ QUALITY EARLY LEARNING INITIATIVE


This system will provide a set of standards that describe the requirements that center‐ and home‐

based early learning programs must meet in order to qualify for a QRIS rating; the higher the quality,

the higher the rating. The QRIS will support early learning educators with increased training,

technical assistance support, and incentives to participate; provide families with information about

the type of learning and care their young children receive; and inform policymakers and the general

public about the effectiveness of programs. In FY 12‐13, there were 43 state and federally funded

classroom sites (from 9 child development programs) participating in Race to the Top quality efforts

in Santa Cruz County.

California is taking a unique approach that will allow county collaborations (consortiums) to develop

and maintain control over their own quality improvement processes, while still allowing counties to

coordinate efforts when feasible and share lessons learned. Each county consortium will align their

local QRIS to a common “Quality Continuum Framework” and will implement the state‐approved

tiers, in addition to any locally‐determined tiers. The California Department of Education (CDE)

designated First 5 Santa Cruz County as the lead agency for Race to the Top in this county.

Additionally, CDE is providing 10 one‐time investments to support local efforts including

teacher/provider training and professional development; kindergarten readiness; community care

licensing; home visitation; developmental screenings; and

evaluation of local QRIS efforts. In FY 12‐13, CDE funded WestEd to

provide The Teaching Pyramid trainings16 to all participating RTT

counties. This comprehensive evidence‐based training and

coaching model is designed to help early childhood educators

promote social‐emotional competence in young children, address

challenging behaviors, and develop safe and nurturing group

environments for all children.

The Santa Cruz County Office of Education facilitated this 5‐series training with stipends support by

First 5 Santa Cruz County for 84 teachers from all 9 participating RTT child development programs.

Child Signature Program (CSP) 17

In 2012, Santa Cruz County received approval and funding to participate in First 5 California’s Child

Signature Program. This program was created to provide all 58 counties the opportunity to increase

quality in early learning programs for children ages 0‐5 in early care and education (ECE) centers

where the educational divide is greatest (i.e., neighborhoods in catchment areas of elementary

schools with Academic Performance Index scores in deciles 1‐3).

16 The Teaching Pyramid was developed by the Center on the Social and Emotional Foundations for Early Learning (CSEFEL) and enhanced for California by WestEd, in collaboration with the California Collaborative on the Social‐Emotional Foundations for Early Learning (CA CSEFEL).

17 The Child Signature Program has three “strands” that have different scopes, and which were initiated through three different Requests for Application (RFA). First 5 Santa Cruz County was awarded funding for CSP RFA #2: “Readiness Assessment and Quality Improvement.” For simplicity, this program is referred to as the Child Signature Program, or CSP, and the RFA number is omitted.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ QUALITY EARLY LEARNING INITIATIVE


“At‐risk children who receive

high‐quality early care and

education benefit greatly,

often exceeding national

averages on measures of

school readiness…[and]

these gains persist”

‐ First 5 California

The Child Signature Program accomplishes two major purposes:

Completion of a Readiness Assessment in each classroom selected for participation, and

Results from the Readiness Assessment will determine where classrooms need to focus their

efforts to improve quality and engage in training opportunities and technical assistance.

The CSP focuses on providing quality improvement support through training and technical

assistance to local centers and classrooms. Counties participating in the CSP will complete a

Readiness Assessment (RA) on each participating center and classroom, collect data to determine

levels of strength and identify areas for improvement, and engage in training

opportunities designed to advance quality to a higher level throughout

the term of the program. Key personnel will be trained on how to

conduct the CLASS assessment (a measurement of classroom quality),

will receive “Looking At CLASSrooms” (LAC) training (reviewing the

CLASS dimensions), and all participating classroom staff will complete

an online tobacco training titled “Kids and Smoke Don’t Mix.” In Santa

Cruz County, there are 19 state and federally funded sites participating

in the CSP program.

The CSP program also provides funding for an Early Learning Systems

Specialist (ELSS). Recognizing that counties have sites with classrooms at varying levels of quality,

the ELSS will be responsible for coordinating and facilitating training, technical assistance, and other

support for identified centers and classrooms selected by the county to work toward achieving the

CSP Baseline Criteria, Teacher/Provider Qualifications, and/or the CSP quality enhancement

program elements.

Local Quality Rating and Improvement System (QRIS)

First 5 established the Santa Cruz County Quality Early Learning Initiative (QELI) Consortium,

bringing together organizations, stakeholders, and 22 early learning professionals who shared a

commitment to improving the quality of early learning and creating a county‐wide Quality

Improvement Plan (QIP). Together, members of the QELI Consortium have been working to achieve

coherence and alignment in developing and piloting a local Quality Rating and Improvement System

(QRIS) as a way to foster ongoing improvement of early care and education programs in Santa Cruz

County.

The QELI Consortium adopted the Hybrid Quality Continuum Framework and Tiers as the foundation

of their local QRIS. This framework identifies five tiers of quality, with points assigned to each tier

for seven elements of quality, such as teacher‐child ratios, teacher qualifications, and teacher‐child

interactions (for more information, see Appendix B). Sites receive a cumulative score based on their

ratings that will eventually become publicly available to families seeking child care and early learning

programs. It is important to note that the QRIS isn’t just a rating system; it is also an improvement

system. Participating child care sites receive support, training, and financial incentives to make

improvements that lead to higher ratings and ultimately to higher quality child care programs.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ QUALITY EARLY LEARNING INITIATIVE


Quality Improvement Activities

First 5 contracted with Encompass Community Services (formerly known as Santa Cruz Community

Counseling Center) to lead the QELI Consortium’s quality improvement activities, due to the

organization’s extensive experience operating quality Head Start programs. During this past year,

the Early Learning System Specialist (ELSS) employed by Encompass completed Readiness

Assessments with all CSP classrooms, coordinated trainings related to CSP and RTT‐ELC, provided

technical assistance to program directors, developed processes for maintaining centralized records

and began conducting the QRIS baseline ratings. The following table presents the number of early

childhood educators who participated in QELI trainings provided in 2012‐13.

JULY 1, 2012 – JUNE 30, 2013

Number of early childhood educators in RTT‐ELC sites who received stipends to participate in “The Teaching Pyramid” trainings and coaching

84

Number of early childhood educators in CSP classrooms who attended the “CLASS Overview,” “Looking at CLASSrooms” (LAC), or “Kids and Smoke Don’t Mix” trainings

50*

* Many early childhood educators in CSP classrooms attended more than one of these trainings.

Bay Area Quality Rating Improvement System Partnership

Santa Cruz County has joined with Santa Clara, San Francisco, Alameda, and Contra Costa counties

to form the Bay Area Quality Rating Improvement System Partnership (BAQRISP). This regional

consortium was developed so these neighboring counties could strategize together, share

resources, leverage funds, and align practices. It is anticipated that this regional approach will result

in strengthening the current resources available for professional development and coaching.

The counties in this consortium will also develop and share a common data system called the Bay

Area Regional RTT Database, which will be designed to gather scoring information, track supports

and incentives, ensure participation by targeted programs serving children with High Needs, and

review progress in relation to the Consortium’s local quality improvement targets.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ STARLIGHT CHILDREN’S CENTER


Starlight Children’s Center

Program Description

The Starlight Children’s Center (SCC) is a new program for families of children 0‐3 years old. Much

like the original Starlight Infant/Toddler Program (SITP), SCC offers a wide variety of comprehensive

bilingual services for expectant parents and families with infants and toddlers. It is located in the

Starlight Elementary School catchment area of Watsonville, an area with one of the highest

populations of children under the age of five living in poverty in the County. A key goal is to create a

“learning community” that promotes early literacy and social/emotional skills to help lay a solid

foundation for school readiness.

The program provides center‐based services for 10 children, through collaborative funding with the

Early Head Start Program, and operates four days per week for six hours per day. In addition, the

program provides 20 families with home‐based services which include weekly home visits and two

socializations per month. Both center‐ and home‐based services follow the criteria for the federally

funded Early Head Start program, and SCC families receive priority enrollment into Head Start pre‐

school classes once the child turns three years old.

Both the center and home based teachers utilize an “evidence based” curriculum specifically

designed for their specific program option; Creative Curriculum for the center‐based, and Partners

for a Healthy Baby for the home‐based. Activities are augmented through a wide variety of

additional supports that include literacy, health, and early childhood development information.

These activities include speakers, special trainings and family literacy classes.

“Nicolas has been with us since the beginning of the year and has an Individualized Family Service Plan (IFSP) for speech delays. He was born deaf and remained deaf for one year, at which point he began to hear. Because of this, his speech development was behind schedule. Nicolas’ mom is a single mom and also has two other sons. She is legally blind in one eye, is permanently disabled, and has other health problems as well.

While Nicolas has been in school with us, his mother has been able to attend to her many health issues, and Nicolas has flourished. His language has developed exponentially and he now speaks in complete sentences and has a larger and more fluid vocabulary than any other child in the classroom. His social-emotional development and vocabulary is advanced and it is not uncommon to hear him say things like, “No me peges. No me gusta.” (“Don’t hit me. I don’t like it.”) He participates actively in circle time, and has learned the words to songs and the hand movements that go along with them. Mom and the speech therapist are both extremely happy with Nicolas’ progress since being in our program.”

- Starlight Children’s Center, Annual Progress Report

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ STARLIGHT CHILDREN’S CENTER


Population Served

2012‐2013


Children (Total) 37

(Center‐based) 10(Home‐visited) 37


Outcome Objective: Parents will expand their literacy activities with their children

2012‐2013

Between July 1, 2012 and June 30, 2013, 100% of all participating families will complete an initial assessment, a family partnership agreement, a nutritional assessment, and health and dental screenings.

100% N=39

By June 30, 2013, 80% of parents will report an increase of activities with their children that stimulate their child’s development.

100% N=17

By June 30, 2013, 90% of families will identify family literacy goals in their Family Partnership Agreement.

100% N=39

By June 30, 2013, 80% of parents will report an increase in literacy activities with their children.

100% N=39

Source: Starlight Children’s Center, Annual Progress Report, 2013; (Increase in literacy activities) Starlight Children’s Center, 2013.

Outcome Objective: Children’s development will be assessed

2012‐2013

By June 30, 2013, 100% of enrolled children will be screened in developmental and social‐emotional areas using the ASQ/ASQ:SE.

100% N=39

Percentage of assessed children who fell below appropriate developmental thresholds:

20.5% N=39

By June 30, 2013, 100% of those children who fall below thresholds of appropriate development will receive individualized support and follow up, including rescreening and/or referrals to community agencies as indicated.

100% N=8

By June 30, 2013:

Center‐based: Center‐based children will be assessed with the DRDP‐I/T. Assessments will be conducted and analyzed three times a year in October, February, and June. Supports for families in specific areas of language and literacy will be tailored based on the first two assessments, and a comparison will be made to see if there have been gains throughout the year.

Home‐visited: Children enrolled in the home‐visiting program, ages 0‐3, will be assessed using selected indicators from the New Portage Guide. Measurement and outcomes will be determined after the program has fully implemented the assessment.

DRDP‐I/T:

During this 1st year of the SCC program, 4 children have completed three DRDP‐I/T assessments.

New Portage Guide

During this 1st year of the SCC program, 18 children have completed three Portage assessments.

Source: Starlight Children’s Center, Annual Progress Report, 2013; First 5 Santa Cruz County, DRDP‐I/T analysis template, 2013; Starlight Children’s Center, New Portage Guide results, analyzed by Child Care Results (SCC’s independent contractor), 2013.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ STARLIGHT CHILDREN’S CENTER


In their first 3 years of life, children’s neural pathways are being developed and cemented as a

foundation for a life full of learning. Quality early childhood experiences help to foster better

language skills, higher cognitive functions, as well as improving sensory pathways, according to the

Harvard University Center on the Developing Child. Therefore, literacy promotion doesn’t begin in

preschool – it starts much earlier, even in daily interactions with young babies.

At the Starlight Children’s Center, center staff and home visitors work with parents of infants and

toddlers to build the foundations for literacy. To guide their efforts with children and their families,

they assess children’s health and development using the Ages and Stages Questionnaire (ASQ) and

ASQ: Social/Emotional (ASQ:SE) screening tool, the DRDP – Infant/Toddler (2010) for children

receiving center‐based services, and the New Portage Guide for children receiving home‐based

services.

Results

ASQ/ASQ:SE

o 100% of enrolled children were screened in developmental and social‐emotional areas

using the ASQ/ASQ:SE. Of those children, 21% fell below appropriate developmental

thresholds and received individual support and follow‐up, including rescreening and/or

referrals to community agencies.

DRDP‐I/T

Assessment results show that toddlers in the Starlight Children’s Center are being supported

to develop social and interpersonal skills, and to develop a strong foundation for later

literacy. As seen in the following figure:

o The majority of toddlers increased one or more developmental levels in all measures, with

the greatest increases occurring in “Relationships with Familiar Adults” (100%), and

“Recognition of Symbols” (100%). Due to the low number of toddlers in this analysis, these

should be considered preliminary results.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ STARLIGHT CHILDREN’S CENTER


Figure 80: Percentage of Center-Based Children Who Made Developmental Changes in Key Social and Pre-Literacy Measures

Toddlers (18 – 36 months)

Source: Starlight Children’s Center, Desired Results Developmental Profile I/T (2010), 2012‐2013

* Only these four questions with 6 developmental levels have the ability to increase 5 levels.

Notes:

Clients were assessed in the fall, winter and spring. Due to the marked programmatic changes between this new Starlight Children’s Center and its predecessor (Starlight Infant/Toddler Program: SITP), it was decided to treat all children as new clients. Therefore, all children’s fall 2012 assessments were considered their baseline assessments, even if they had begun their services earlier. However, some children were newly enrolled in the spring 2013, so their spring assessments were considered their baseline assessments.

Only children who completed at least the first and third assessments have been included in this analysis. This analysis excludes children who already scored at the highest developmental level on the 1st assessment. Ages are calculated as of the date of the 3rd assessment; no infants completed three assessments this fiscal year.

N=4. Due to the low number of clients, results should be interpreted with caution.

New Portage Guide

The New Portage Guide Birth to Six is a developmental assessment tool based on direct

observations of typical milestone skills in five domain areas, rated as either: No/Not

observed, Occasionally/Emerging Skill area, or Consistently/Mastered. “Mastery” of an

indicator means that the child consistently demonstrates the skill in a variety of settings.

Assessments are completed three times a year for each child to document their growth and

development, measure progress and plan individualized activities.

25.0% 25.0%

50.0% 100.0% 50.0%

75.0%

50.0% 50.0%

75.0%

100.0%

25.0% 25.0% 25.0%

25.0%

50.0%

25.0%25.0%

0%

20%

40%

60%

80%

100%

Increased 3 Levels

Increased 2 Levels

Increased 1 Level

No Change in Levels

Decreased in Levels

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ EARLY LITERACY FOUNDATIONS INITIATIVE


Early Literacy Foundations (ELF) Initiative

Program Description

California 3rd graders are struggling to become proficient readers. Local and statewide data indicate

that well over half of 3rd grade children are not reading at proficiency. Because language

development in the early years is crucial to later reading success, early childhood educators have a

unique role in influencing language and literacy development and later educational success.

According to a report published in the Journal of Education Psychology, early childhood educators

play a key role in the language development of children from high poverty backgrounds:

“Language development has a profound effect on young children’s successful transition to school

and, in particular, on their success in learning to read. Children who arrive in first grade with a

foundation in pre‐literacy skills and the interest and motivation to learn are better prepared to

engage in the complex task of learning to read.

Most children acquire language and pre‐literacy skills through interactions with adults and peers

who use language in ways that are consistent with the majority culture and correspond to the

printed word. Unfortunately, many children raised in poverty have limited access to opportunities

to develop language and literacy skills in such ways.

As one important illustration, Hart and Risley (1995) reported that by the age of 3, children in

poverty were already well behind their more affluent peers in their acquisition of vocabulary and

oral language skills. Snow et al. (1998) also reported that children in poverty lack necessary

pre‐literacy skills at the beginning of kindergarten. Similar research indicates that socioeconomic

status is the strongest predictor of performance differences in children at the beginning of the first

grade and that this gap persists as children progress from elementary to high school.”18

With the evidence of limited language and literacy opportunities in low‐income homes, more

emphasis has been placed on showing early childhood educators how to build language

opportunities into their daily child care routines, through fun and meaningful instruction. First 5’s

Early Literacy Foundations Initiative builds skills among early childhood educators to promote strong

literacy and language foundations for young children.

The ELF Initiative features:

1. Professional development for family child care providers working with Spanish speaking

children through SEEDS of Early Literacy training and coaching. Training includes

opportunities to create literacy‐based materials to use in the family child care home

environment through “Make and Take” workshops. This program is described in more detail

in the following pages.

18 American Psychological Association (2006). The Effects of a Language and Literacy Intervention on Head Start Children and Teachers. Journal of Educational Psychology, 98, (1), 63–74.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ EARLY LITERACY FOUNDATIONS INITIATIVE


2. Expansion of the SEEDS Plus program, designed for “graduates” of the SEEDS of Early

Literacy classes. This course is designed to promote and embed the ongoing use of SEEDS

strategies, identify children who will receive tailored literacy‐based interventions, and

increase the number of children on target with early reading predictors. This academic year‐

long program is described in more detail in the following pages.

3. Development and implementation of the new Santa Cruz Reading Corps. This program

places one AmeriCorps volunteer (called a Preschool Literacy Tutor) in each State Preschool

classroom at both the Pajaro Valley Unified School District and Live Oak School District. The

goal of this program is to develop children’s early literacy skills in English in preparation for

kindergarten. The Preschool Literacy Tutors are trained in research‐based strategies

following the SEEDS of Early Literacy curriculum, collaborate with the classroom teaching

staff to enhance daily literacy opportunities, and conduct literacy assessments to provide

individualized support to help children in Santa Cruz County become successful readers by

3rd grade. This program is described in more detail in the following pages.

4. Assessment of children’s development of early literacy skills in participating State Pre‐K

classrooms via the Individual Growth and Development Indicators (IGDI’s) tool. These

assessments help teachers identify children who need individualized instruction in early

literacy strategies.

5. Family Engagement through continuation of the “Raising A Reader” weekly rotating book

bag program. All Raising A Reader classrooms have SEEDS trained staff, resulting in mutually

complimentary interventions to boost shared reading practices with children and their

families, and to impact children’s early literacy skills. Information on this program can be

found in the Raising A Reader partner profile.

6. The Santa Cruz Public Libraries (SCPL) “Read to Me” program provides Read to Me Resource

Kits for parents and early childhood educators via library circulation to engage children and

families in early literacy activities. This year new math and science kits called “Let’s Play,”

geared for children 3‐8 years old, were developed and added to circulation.

The following descriptions provide more detailed information about the SEEDS of Early Literacy,

SEEDS Plus, and the Santa Cruz Reading Corps.

SEEDS of Early Literacy

This professional development initiative follows the SEEDS of Early Literacy curriculum that has been

researched by the University of Minnesota. Research on the SEEDS model shows that teachers trained

and coached on the SEEDS of Early Literacy curriculum score significantly higher on the Early

Language and Literacy Classroom Observation (ELLCO) tool and show greater change over time in

teaching strategies than teachers without such training or coaching. Results also indicate that

preschool children who were taught by teachers trained in SEEDS entered kindergarten ready to

read at higher rates than children in non‐SEEDS groups (Lizakowski, 2005).



The SEEDS Professional Development model consists of training—and providing coaching to—early

childhood educators on how to effectively integrate research‐based language and literacy strategies

and materials into their classrooms. In 2012‐2013, Family Child Care Providers were engaged in

instruction and “Make and Take” workshops that taught strategies of both embedded instruction

(planned strategies that occur within the typical routines of the class day) and explicit instruction

(teacher‐directed activities that emphasize the teaching of a specific task), and to create a family

home environment that is designed to target early literacy predictors.

These predictors of later reading success include:

Conversation and Oral Language: The ability to produce or comprehend spoken language

Alphabet Knowledge: The ability to visually discriminate the differences between letters

and say the names and sounds associated with printed letters

Book and Print Rules: Refers to what children understand about how books and print work,

such as left‐right, front‐back, letters, words and that print has meaning

Phonological awareness: The ability to detect, manipulate, or analyze the auditory aspects

of spoken language, including the ability to distinguish or segment words, syllables, rhymes,

and beginning sounds

Vocabulary and Background Knowledge: A collection of words that relate to experiences

and knowledge that a child has of the world around him/her

This diagram displays the five essential SEEDS quality interactions and the five predictors of literacy.



SEEDS Plus

The SEEDS Plus program for FY 12‐13 was expanded to include a full academic year, and was

designed for “graduates” of the SEEDS of Early Literacy classes. In an effort to support teachers as

they worked to embed the SEEDS concepts into daily practice, this nine‐month course was designed

to focus on the SEEDS strategies through embedded and explicit instruction, modeling, practice, and

one‐on‐one weekly coaching.

The objectives of SEEDS Plus included:

Supporting teachers who work with children at risk for low language and literacy

opportunities.

Assessing and promoting the ongoing use of SEEDS strategies following prior SEEDS course

completion, for quality language and literacy support.

Promoting the use of Response to Intervention (RtI) strategies, that help early childhood

teachers recognize children who need tailored literacy support, and to respond in ways that

help the children experience early school success.

Increasing the number of children on target with early reading predictors.

Each participant in SEEDS Plus received:

15 instructional sessions

20 on‐site coaching visits

4 literacy labs and 6 children’s books to use in their centers

In October, each SEEDS Plus participant conducted an initial benchmark assessment of children’s

emergent language and literacy skills using the Individual Growth and Development Indicators

(IGDI’s) assessment, to which was added assessments of letter names and letter sounds. Based on

this initial benchmark, SEEDS Plus participants chose up to five pre‐Kindergarten children to receive

tailored literacy‐based intervention strategies. These children’s progress was monitored every four

weeks throughout the program, with a winter benchmark assessment conducted in February and a

final spring benchmark assessment conducted in May.

Santa Cruz County’s SEEDS and SEEDS Plus programs have proven to be very effective at

strengthening classroom environments and practices, as well as influencing changes in children’s

skills on research‐based predictors of early reading.




AmeriCorps is a national service organization with about 100,000 members serving across the

United States to help meet critical needs in the areas of education, health, the environment,

disaster services, veterans, and economic opportunity. In the summer of 2012, First 5 Santa Cruz

County partnered with AmeriCorps19 to create the Santa Cruz Reading Corps (SCRC), which places 12

AmeriCorps volunteers in state preschool and transitional kindergarten classrooms in both the Live

Oak and Pajaro Valley Unified School Districts.

The focus of the SCRC is to promote strong literacy and language foundations for young children,

especially dual language learners. Local and statewide data indicate that well over half of 3rd grade

children in California—and Santa Cruz County—are not reading at proficiency. Research shows that

when students get off to a poor start in reading, they rarely catch up with other students. Happily,

research also shows that almost all children have the capacity to learn to read proficiently if

effective interventions are provided. Due to the fact that language development in the early years is

crucial to later reading success, the SCRC members are using the evidence‐based SEEDS of Early

Literacy curriculum to help boost the early literacy skills of children in English as they prepare to

enter kindergarten.

During the academic school year (running from September to May) SCRC members—called

Preschool Literacy Tutors—collaborate with the classroom teaching staff to enhance daily literacy

opportunities, and provide support to classrooms’ routines by implementing specific research‐based

strategies from the SEEDS of Early Literacy curriculum. Each tutor receives extensive training,

individualized coaching, and support to track and guide children in English language development

through one‐on‐one and small group interventions. SCRC tutors also facilitate Raising A Reader, the

weekly rotating book bag program that provides books and support for families to read aloud with

their children.

In addition to their daily work with students, tutors assess each child in their classroom three times;

once in October, once in early February, and once in May, in five areas of early reading predictors

(rhyming, alliteration, letter names, letter sounds, and vocabulary development). These assessments

help them select five children who receive tailored literacy‐based interventions on a daily basis.

Each of these children’s progress is monitored monthly to see if the interventions are effective. The

goal of the SCRC is to increase the number of children on target with early reading predictors.

Through all these efforts, children are provided the assistance they need to enter kindergarten more

school‐ready and to become fluent readers by 3rd grade.

19 In 2001, representatives of the First 5 California and the First 5 Association were invited by the Governor’s Office on Service and Volunteerism (GO SERV) to discuss the utilization of AmeriCorps members in First 5 funded programs and initiatives. Through this partnership, the First 5 Service Corps was developed. In this report, this collaboration is simply referred to as AmeriCorps.



Early Literacy Foundations (ELF) Initiative

Population Served

THIS FUNDING CYCLE

2012‐2013

CUMULATIVE

TOTALS

2007‐2013


Number of SEEDS Quality Coaches providing literacy coaching, literacy environmental assessments, and professional development advising for SEEDS instruction, fidelity, and integrity during the year

14 52

Number of early childhood educators attending SEEDS of Early Literacy workshops 28 383

Number of early childhood educators attending the SEEDS Plus program 15 41

Number of Family, Friend or Neighbor (FFN) informal child care providers attending SEEDS of Early Literacy workshops

0 155*

Number of Reading Corps tutors who received SEEDS training 12 12

TOTAL (unduplicated) 69 559

CHILDREN

Number of children in classrooms with a Reading Corps tutor 509 509

Source: Early Literacy Foundations (ELF) Initiative, 2007‐13.

The following figures show additional data about Early Childhood Educators and Coaches who have

been trained between 2007‐2013.

Figure 81: Number of SEEDS-Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007-2013)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, 2012‐2013.

Note: SEEDS‐Trained Early Childhood Educators include participants in the “basic” SEEDS classes and SEEDS Plus classes, and SEEDS coaches. Family, Friend or Neighbor (FFN) informal child care providers and Santa Cruz Reading Corps Preschool Literacy Tutors are not included in these analyses.

Educators in State and Federally‐Subsidized

Classrooms

Educators in Licensed Family Child Care Homes and

Private/ Non‐Profit Centers

Unduplicated total, Spring 2007 – June 2013

207 185 392



Figure 82: Key Demographics of SEEDS-Trained Early Childhood Educators in Licensed Programs (2007-2013)

Primary Language

Educational Attainment

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Client and Assessment Data Entry Template, 2012‐2013.

Note: SEEDS‐Trained Early Childhood Educators include participants in the “basic” SEEDS classes and SEEDS Plus classes, and SEEDS coaches. Family, Friend or Neighbor (FFN) informal child care providers and Santa Cruz Reading Corps Preschool Literacy Tutors are not included in these analyses.

Early childhood educators and coaches may have participated in more than one SEEDS class, but are only counted once in these analyses. For these clients, their language and education data are as of their earliest class, in order to assess the status of these educators at the beginning of their participation in the SEEDS program. Educators might also speak other languages that they do not consider their primary language.

N: (Language) N=407; (Education) N=376.

Outcome Objective: Increase the number of early education settings that provide high quality support for language and literacy

Preschool Classrooms

Research on teacher effectiveness shows that by focusing professional development on language

and literacy and social/emotional development, children are much better prepared for school and

have higher academic achievement. The first indicators of change are the language environment,

teacher‐child interactions, and language opportunities that teachers provide to children.

First 5 SEEDS Quality coaches are trained to assess SEEDS classrooms that are teaching children ages

3‐5, using the Early Language and Literacy Classroom Observation Pre‐K Tool (ELLCO Pre‐K). The

ELLCO Pre‐K is used to assess the following five classroom components: “Classroom Structure,”

“Curriculum,” “Language Environment,” “Books and Book Reading,” and “Print and Early Writing.”

26.0%

48.9%

22.1%

2.9%

English Only

Spanish Only

Bilingual English/Spanish

Other

8.8%

9.3%

21.0%

26.6%

6.1%

10.9%

8.5%

4.0%4.8% No Formal Schooling

Less Than High School Diploma/GED

High School Diploma/GED

Some College

AA in non‐ECE/CD

AA in ECE/CD

BA in non‐ECE/CD

BA in ECE/CD

Some Graduate School or Postgraduate Degree



Items are scored along a 5 point scale, where 1 is deficient and 5 is exemplary. From this scale, early

childhood educators’ classroom scores can be categorized into three levels, indicating their

classroom environment provides low‐quality support, basic support, or high‐quality support for

language and literacy. In every Pre‐K SEEDS course since 2007, coaches used the ELLCO to assess

the classrooms of their mentees (early childhood educators receiving SEEDS training) at the

beginning and end of the semester. The results were then used as a coaching tool, supporting

teachers in setting early literacy goals.

Results In 2012‐13, only SEEDS Plus participants used the ELLCO Pre‐K tool. As the SEEDS Plus program is

designed for “graduates” of the SEEDS of Early Literacy classes, the following results demonstrate

the higher level of skill of these more experienced early childhood educators at pre assessment.

Across all components, classrooms showed improvements from the beginning of the

semester to the end. Even so, a high percentage of these SEEDS Plus classrooms were already

providing high‐quality support at the beginning of the year, demonstrating the skill of these

previously‐trained SEEDS educators.

Overall, the percentage of classrooms taught by SEEDS Plus participants that were rated as

having High‐Quality Support increased from 67% to 100%.

Among the individual sections of the ELLCO Pre‐K, by the end of the semester all of classrooms

(100%) were rated as having High‐Quality Support in “Classroom Structure,” “Curriculum,”

“Language Environment,” “Books and Book Reading,” and “Print and Early Writing.”

Figure 83: Preschool Classrooms of SEEDS Plus participants: Support for Language and Literacy (2012-2013)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Early Language and Literacy Classroom Observation (ELLCO) Pre‐K, 2012‐2013 Note: Low‐quality support = means less than or equal to 2.5; Basic support = means between 2.51 and 3.5; High‐quality support = means between 3.51 and 5. Percentages less than 3% are not labeled. This analysis includes data from SEEDS coaches, early childhood educators who attended SEEDS of Early Literacy courses, and SEEDS Plus participants; however, in 2012‐13, only SEEDS Plus participants completed this assessment. N=15.

6.7% 6.7% 6.7% 13.3%13.3%

53.3%

60.0%

26.7%

53.3%

33.3%

80.0%100.0%

46.7%

100.0%

33.3%

100.0%

66.7%

100.0%

33.3%

100.0%

66.7%

100.0%

0%

20%

40%

60%

80%

100%

Pre Post Pre Post Pre Post Pre Post Pre Post Pre Post

Low‐Quality Support Basic Support High‐Quality Support

Section 1: Classroom Structure

Section 2: Curriculum

Section 3: The Language Environment

Section 4: Books & Book

Reading

Section 5: Print & Early

Writing

Overall



Four specific ELLCO items were chosen for individual study, using the same type of analysis of

classroom quality: Opportunities for Child Choice and Initiative, Approaches to Book Reading,

Support for Children's Writing, and Approaches to Curriculum. For these four items, several years of

data have been aggregated in order to present a more robust portrait of the extent to which SEEDS‐

trained early childhood educators were providing high quality support for language and literacy in

their preschool classrooms.

Results

As reflected in this figure, SEEDS‐coached teachers have consistently improved the quality of

support they provide in their classrooms for children’s development of early literacy.

For each of the four ELLCO items, the majority of classrooms were rated as providing high

quality support at post assessment: Opportunities for Child Choice and Initiative (95%),

Support for Children's Writing (89%), Approaches to Curriculum (89%), and Approaches to

Book Reading (88%).

Figure 84: Preschool Classrooms of all SEEDS-Trained Early Childhood Educators: Key Language and Literacy Supports (2007-2013)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Early Language and Literacy Classroom Observation (ELLCO) & ELLCO Pre‐K, 2007 – 2013.

Note: Clients may be included more than once if they participated in multiple SEEDS classes during these years. Low‐quality support = means less than or equal to 2.5; Basic support = means between 2.51 and 3.5; High‐quality support = means between 3.51 and 5. Percentages less than 3% are not labeled. This analysis includes data from SEEDS coaches, early childhood educators who attended SEEDS of Early Literacy courses, and SEEDS Plus participants.

N: (Child Choice and Initiative) N=188, (Book Reading) N=269, (Children's Writing) N=275, (Approaches to Curriculum) N=188.

* The analysis of these questions marked with an asterisk began in 2007‐08, so results reflect the combined data for 2008‐2013.

9.0% 15.6% 19.6% 21.8%

35.6%

5.3%

50.9%

10.8%

49.1%

10.5%

39.9%

10.6%

55.3%

94.7%

33.5%

88.1%

31.3%

89.1%

38.3%

88.8%

0%

20%

40%

60%

80%

100%

Pre Post Pre Post Pre Post Pre Post


Approaches to Book Reading

Opportunities for Child Choice and

Initiative*

Support for Children’s Writing

Approaches to Curriculum*



Family Child Care Settings

The data above describe the ways that SEEDS‐trained teachers made changes to their preschool

classroom environments and their practices in order to better support children’s development of

pre‐literacy skills. However, SEEDS training was not just limited to preschool center teachers — early

childhood educators from family child care settings also participated in SEEDS training and received

SEEDS coaching. Their sites were observed at the beginning of their SEEDS training and again at the

end.

Child/Home Early Language and Literacy Observation (CHELLO) is a tool designed to rate the early

literacy environment in home‐based child care settings of children ages birth to 5 years. Two

sections of the CHELLO tool were used to assess home‐based classrooms: the Group/Family

Observation section and the Literacy Environment Checklist. For the Group/Family Observation

section, items were scored along a 5 point scale, where 1 is deficient and 5 is exemplary. Like the

ELLCO analyses, early childhood educators’ classroom scores were categorized into three levels,

indicating their classroom environment provided low‐quality support, basic support, or high‐quality

support for language and literacy. Scores on the Literacy Environment Checklist ranged from 1 to

26, and were similarly categorized into three levels of support (Poor, Fair, Excellent).

Results

In 2012‐13, there were two cohorts of licensed family child care providers who participated in

SEEDS; one in the fall and one in the spring. Educators in fall 2012 received a 7‐week SEEDS training,

received 7 one‐on‐one coaching sessions, and conducted CHELLO assessments in their home‐based

classrooms. Educators in spring 2013 received home‐based coaching and training through three

informal “Make and Take” workshops that focused on the basic early literacy strategies called the

“Big Five.” In this format there were fewer requirements and they did not conduct the CHELLO

assessments in their programs.

The following figures present the PRE and POST scores gathered from the fall cohort of early

childhood educators in family child care settings for infants/toddlers, using the CHELLO tool. Across

all components, classrooms showed substantial improvements from the first training to the final

training.

Results from the Group/Family Observation section showed that overall, the percentage of

family child care settings that were rated as having High‐Quality Support increased from 50%

to 92%.

Among the individual Group/Family Observation components, by the end of the trainings the

majority of family child care settings were rated as having High‐Quality Support in “Physical

Environment for Learning” (92%), “Support for Learning” (83%), and “Adult Teaching

Strategies” (75%).

Scores on the Literacy Environment Checklist showed that the percentage of family child care

settings that were rated as having Excellent Support increased from 33% to 58%.



Figure 85: Family Child Care Settings: Support for Language and Literacy (2012-2013)

Group/Family Observation

Literacy Environment Checklist

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Child/Home Early Language and Literacy Observation (CHELLO), 2012‐2013

Note: Low‐quality support = means less than or equal to 2.5; Basic support = means between 2.51 and 3.5; High‐quality support = means between 3.51 and 5. Percentages less than 3% are not labeled. This analysis includes data from family child care providers who attended SEEDS of Early Literacy workshops in Fall 2012.

N: (Group/Family Observation)=12; (Literacy Environment Checklist)=12.

SEEDS Plus program

The SEEDS Plus program was designed for “graduates” of the SEEDS of Early Literacy classes. This

course promoted the use of Response to Interventions (RtI) strategies as a way to provide children

with tailored literacy support and increase the number of children on target with early reading

predictors. Early childhood educators in SEEDS Plus assessed children’s pre‐literacy skills in the three

skill areas measured by the Individual Growth and Development Indicators (IGDI’s) assessment tool

(Picture Naming, Rhyming, Alliteration), and also in the two skill areas of Letter Naming and Letter

Sounds.

8.3%16.7%

41.7%

16.7%

50.0%

8.3%

25.0%

16.7%

25.0%

25.0%

33.3%

8.3%

41.7%

91.7%

58.3%

83.3%

33.3%

75.0%

50.0%

91.7%

0%

20%

40%

60%

80%

100%

Pre Post Pre Post Pre Post Pre Post


8.3%

58.3%

41.7%

33.3%

58.3%

0%

20%

40%

60%

80%

100%

Pre Post

Excellent Support

Fair Support

Poor Support

Physical Environment for Learning

Support for Learning

Adult Teaching Strategies

Overall



As the majority of students were dual language learners, many children were assessed in both

English and Spanish. In 2012‐13, there was an emphasis in all “SEEDS” classrooms on developing and

improving children’s vocabulary skills in English. Children whose primary language was Spanish were

assessed using the IGDI’s tool in both English and Spanish. Once children demonstrated proficiency

in their scores on the English‐language assessments, they did not continue taking the Spanish‐

language assessments.

Results

There was interest in focusing on the performance of children when assessed in their primary

language. When looking at the percentage of children who were meeting targets in five predictors of

later reading success (scoring “At” or “Above” target level), results showed that:

On average, children improved in all five pre‐literacy skill areas between their first (October)

and final (May) benchmark assessments.



o Primarily Spanish‐speaking children made the greatest improvements in Alliteration (they

were not assessed in the Letter Naming or Letter Sounds skill areas).




greater amount of improvement in Alliteration and Letter Naming, and equaled the

English‐speaking children’s amount of improvement in Rhyming and Letter Sounds.





Figure 86: SEEDS Plus Classrooms: Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012-2013)


9.8% 2.7% 5.0%

27.3%

12.8%

32.5%

17.1% 14.6%

40.2% 38.4%43.3%

34.9%39.6%

50.5%58.4%

0%

20%

40%

60%

80%

100%

Picture Naming Rhyming Alliteration Letter Naming Letter Sounds

1st Benchmark (Oct.) 2nd Benchmark (Feb.) 3rd Benchmark (May)

English Assessment




Figure 87: SEEDS Plus Classrooms: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012-2013)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, SEEDS Plus Individual Growth and Development Indicators (IGDI’s)

Assessment Tool, 2012‐2013.

Note: Children who completed at least (any) two benchmark assessments within a pre‐literacy skill area were included in the analysis of that skill.


English N= Fall: Picture Naming (112), Rhyming (74), Alliteration (60), Letter Naming (88), Letter Sounds (86). N= Winter: Picture Naming (123), Rhyming (111), Alliteration (103), Letter Naming (92), Letter Sounds (86). N= Spring: Picture Naming (120), Rhyming (109), Alliteration (101), Letter Naming (93), Letter Sounds (89). Spanish/Spanish N= Fall: Picture Naming (114), Rhyming (87), Alliteration (79). N= Winter: Picture Naming (129), Rhyming (103), Alliteration (105). N= Spring: Picture Naming (103), Rhyming (98), Alliteration (99). Spanish/English N= Fall: Picture Naming (161), Rhyming (121), Alliteration (128), Letter Naming (146), Letter Sounds (142). N= Winter: Picture Naming (193), Rhyming (161), Alliteration (157), Letter Naming (137), Letter Sounds (136). N= Spring: Picture Naming (185), Rhyming (161), Alliteration (161), Letter Naming (151), Letter Sounds (151).

1.8%12.6% 12.7%

2.5% 2.5% 3.9% 4.8% 6.3%

18.6%30.1%

40.0%

7.8% 11.8%

22.3%19.0%

31.6%31.1%

45.9%

69.7%

17.3%

32.3%41.6% 41.7%

51.7%

0%

20%

40%

60%

80%

100%

PictureNaming

Rhyming Alliteration LetterNaming*

LetterSounds*

PictureNaming

Rhyming Alliteration LetterNaming

LetterSounds


33.5% 32.2% 34.6%

23.2%

45.6%

29.3%33.3%

57.0%

14.8%

29.8%

37.7% 36.9%

45.4%

0%

20%

40%

60%

80%

100%


English Assessment

Primarily Spanish‐Speaking Children Spanish Assessment English Assessment

English AssessmentSpanish Assessment



An analysis of the percentage of children who scored at each of the target levels (Below, Near,

At/Above), at both the first (October) and final (May) benchmark assessments, shows these results

in more detail. Because of the emphasis on developing and improving children’s vocabulary skills in

English, there was particular interest in analyzing the amount of improvement that children made in

their English abilities, which is highlighted in the following charts.

Figure 88: SEEDS Plus Classrooms: Percentage of Children at Each Target Level in Five Pre-Literacy Skill Areas, in English (2012-2013)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, SEEDS Plus Individual Growth and Development Indicators (IGDI’s)


Note: Children who completed both the first (Oct.) and final (May) benchmark assessments within a pre‐literacy skill area were included in the analysis of that skill.

English N= Fall: Picture Naming (112), Rhyming (74), Alliteration (60), Letter Naming (88), Letter Sounds (86). N= Spring: Picture Naming (120), Rhyming (109), Alliteration (101), Letter Naming (93), Letter Sounds (89). Spanish/English N= Fall: Picture Naming (161), Rhyming (121), Alliteration (128), Letter Naming (146), Letter Sounds (142). N= Spring: Picture Naming (185), Rhyming (161), Alliteration (161), Letter Naming (151), Letter Sounds (151).

51.8%

10.0%

70.3%

33.9%

58.3%

36.6%

67.0%

26.9%

77.9%

30.3%

38.4%

46.7%

27.0%

31.2%

36.7%

23.8%

5.7%

22.6%

9.3%

11.2%

9.8%

43.3%

2.7%

34.9%

5.0%

39.6%27.3%

50.5%

12.8%

58.4%

0%

20%

40%

60%

80%

100%

First Final First Final First Final First Final First Final

Below Near At/Above

Primarily English‐Speaking ChildrenEnglish Assessment

79.5%

30.8%

80.2%

28.0%

76.6%

31.7%

91.1%

35.8%

81.0%

36.4%

18.0%

51.9%

17.4%

39.8%

19.5%

26.7%

4.1%

22.5%

12.7%

11.9%

2.5%17.3%

2.5%

32.3%

3.9%

41.6%

4.8%

41.7%

6.3%

51.7%

0%

20%

40%

60%

80%

100%


Below Near At/Above

Primarily Spanish‐Speaking ChildrenEnglish Assessment

Benchmark

Picture Naming Benchmark

Rhyming Benchmark

Alliteration Benchmark

Letter Naming Benchmark

Letter Sounds

Benchmark


Rhyming Benchmark



Letter Sounds




The Santa Cruz Reading Corps (SCRC) places one AmeriCorps volunteer (called a Preschool Literacy

Tutor) in each State Preschool classroom at both the Pajaro Valley Unified School District and Live

Oak School District. The goal of this program is to develop children’s early literacy skills in English in

preparation for kindergarten. The Preschool Literacy Tutors are trained in research‐based strategies

following the SEEDS of Early Literacy curriculum, collaborate with the classroom teaching staff to

enhance daily literacy opportunities, and conduct literacy assessments to provide individualized

support to help children in Santa Cruz County become successful readers by 3rd grade. During this

pilot year of the SCRC, 12 Preschool Literacy Tutors were trained and placed in 23 classrooms.

Like the SEEDS Plus program, Preschool Literacy Tutors were trained in the use of Response to

Interventions (RtI) strategies as a way to provide children with tailored literacy support. 20 Preschool

Literacy Tutors assessed children’s pre‐literacy skills in the three areas measured by the Individual

Growth and Development Indicators (IGDI’s) assessment tool (Picture Naming, Rhyming, Alliteration),

and also in the two skill areas of Letter Naming and Letter Sounds.

During the analysis of these assessments, there were three particular areas of interest:

Impact of Reading Corps on all children in the classroom. There was interest in looking at

the performance of all children in classrooms that had a Preschool Literacy Tutor (“Entire

Classroom”), as well as the children who received tailored literacy‐based intervention

strategies from these tutors (“Tutored” Children).

Influence of Primary Language. As the majority of preschool students were dual language

learners, many children were assessed in both English and Spanish. In 2012‐13, there was an

emphasis in all “SEEDS” classrooms on developing and improving children’s vocabulary skills

in English. Children whose primary language was Spanish were assessed using the IGDI’s tool

in both English and Spanish. Once children demonstrated proficiency in their scores on the

English‐language assessments, they did not continue taking the Spanish‐language

assessments.

Focus on English skills. Because of the emphasis on developing and improving children’s

vocabulary skills in English, there was particular interest in analyzing the amount of

improvement that children made in their English abilities.

20 Children who received tailored literacy‐based intervention strategies received more frequent monitoring. In addition to the three benchmark IGDI’s assessments, these children took two additional assessments between the 1

st and 2

nd benchmark assessments (called

Progress Monitorings 1 and 2), and then two more assessments between the 2nd and 3

rd benchmark assessments (called Progress

Monitorings 3 and 4). If a child demonstrated sufficient improvement by the 2nd benchmark assessment, the intervention was ended

with that child and was begun with another child who was not on target with early reading predictors at that time. This new child then received two additional assessments between the 2

nd and 3

rd benchmark assessments (Progress Monitorings 3 and 4). Consequently,

every child who received an intervention was monitored at least two additional times with the Progress Monitoring assessments.



Results

When looking at the percentage of children who were meeting targets for later reading success

(scoring “At” or “Above” target level), results showed that:

On average, both Tutored Children and the Entire Classroom improved in all five pre‐literacy

skill areas—in English—between their first (October) and final (May) benchmark

assessments, no matter what their primary language was.

o On average, a higher percentage of the Entire Classroom were meeting targets for later

reading success than Tutored Children, which makes sense considering that the Tutored

Children were selected based on their lower pre‐literacy skills.

o When examining children in English, English‐speaking children in the Entire Classroom

made the greatest improvements in Letter Sounds, Picture Naming, and Alliteration.

o When examining children in English, Spanish‐speaking children in the Entire Classroom

made the greatest improvements in Letter Sounds, Letter Naming, and Alliteration.

In the Entire Classroom, Spanish‐speaking children particularly demonstrated improvement

in their English language skills.

o When assessed in English, Spanish‐speaking children started with a lower skill level than

English‐speaking children, but by their last assessment they had made a slightly greater

amount of improvement in Letter Naming, and nearly equaled the English‐speaking

children’s amount of improvement in Letter Sounds, Rhyming, and Alliteration.





One Preschool Literacy Tutor’s Story

“Each day I spend extra time with five students who need additional support in their language skills, letter identification, matching and other essential literacy skills. Many of these students who would initially stare at me with blank expressions have built up their English comprehension skills and are able to hold conversations with their peers and myself.

Other students started the school year not knowing how to write the first letter in their name or recite the alphabet. This is no longer the case as I am proud to say that almost all of my students can write their full first name. They can also be found singing the alphabet and rhyming songs from memory on the playground.

I am confident that by the end of the school year in May, every one of my students will have the skills needed to be ready for kindergarten. The resiliency and strength of these students has helped me realize how essential it is to invest in these children’s education now, as it will build a strong foundation for the rest of their lives.”



Figure 89: Reading Corps Classrooms: Percentage of Children At/Above Targets for Later Reading Success, in English (2012-2013)

Entire Classroom English Assessment

“Tutored” Children* English Assessment

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Reading Corps Individual Growth and Development Indicators (IGDI’s)



* “Tutored” Children = Children who received tailored literacy‐based intervention strategies from the Preschool Literacy Tutors.

N: (Entire Classroom) English N= Fall: Picture Naming (140), Rhyming (97), Alliteration (81), Letter Naming (116), Letter Sounds (117). N= Winter: Picture Naming (154), Rhyming (140), Alliteration (128), Letter Naming (120), Letter Sounds (114). N= Spring: Picture Naming (152), Rhyming (138), Alliteration (126), Letter Naming (122), Letter Sounds (119). Spanish N= Fall: Picture Naming (248), Rhyming (198), Alliteration (204), Letter Naming (228), Letter Sounds (224). N= Winter: Picture Naming (290), Rhyming (244), Alliteration (235), Letter Naming (217), Letter Sounds (211). N= Spring: Picture Naming (281), Rhyming (245), Alliteration (238), Letter Naming (230), Letter Sounds (230).

N: (“Tutored” Children) English N= Fall: Picture Naming (18), Rhyming (10), Alliteration (7), Letter Naming (13), Letter Sounds (13). N= Winter: Picture Naming (19), Rhyming (15), Alliteration (13), Letter Naming (16), Letter Sounds (14). N= Spring: Picture Naming (19), Rhyming (15), Alliteration (13), Letter Naming (15), Letter Sounds (15). Spanish N= Fall: Picture Naming (102), Rhyming (77), Alliteration (75), Letter Naming (90), Letter Sounds (91). N= Winter: Picture Naming (109), Rhyming (87), Alliteration (79), Letter Naming (95), Letter Sounds (93). N= Spring: Picture Naming (106), Rhyming (90), Alliteration (84), Letter Naming (92), Letter Sounds (92).

13.6%7.2% 6.2%

24.1%13.7%

2.8% 2.0% 2.9% 4.8% 6.3%

32.5%

19.3% 16.4%

38.3% 36.0%

7.9% 11.1%

20.0% 20.7%28.9%

51.3%

35.5%43.7%

54.9% 58.8%

21.4%

30.2%35.7%

41.7%51.3%

0%

20%

40%

60%

80%

100%

PictureNaming


LetterSounds

PictureNaming


LetterSounds


5.6% 1.3% 2.2% 2.2%

15.8% 13.3% 18.8%7.1% 1.8% 8.0%

16.5% 17.9% 17.2%

36.8%

6.7%

38.5%

20.0%26.7%

14.2%25.6% 22.6%

38.0% 39.1%

0%

20%

40%

60%

80%

100%

PictureNaming


LetterSounds

PictureNaming


LetterSounds








Figure 90: Reading Corps Classrooms: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, in English, Entire Classroom (2012-2013)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Reading Corps Individual Growth and Development Indicators (IGDI’s)



N: English N= Fall: Picture Naming (140), Rhyming (97), Alliteration (81), Letter Naming (116), Letter Sounds (117). N= Winter: Picture Naming (154), Rhyming (140), Alliteration (128), Letter Naming (120), Letter Sounds (114). N= Spring: Picture Naming (152), Rhyming (138), Alliteration (126), Letter Naming (122), Letter Sounds (119). Spanish N= Fall: Picture Naming (248), Rhyming (198), Alliteration (204), Letter Naming (228), Letter Sounds (224). N= Winter: Picture Naming (290), Rhyming (244), Alliteration (235), Letter Naming (217), Letter Sounds (211). N= Spring: Picture Naming (281), Rhyming (245), Alliteration (238), Letter Naming (230), Letter Sounds (230).

Other Outcomes: Children will increase their skills in research-based predictors for reading success

The SEEDS of Early Literacy has shown us that teachers of diverse educational backgrounds can be

trained to implement strategies to help children build a strong language and literacy foundation.

First 5 partnered with SEEDS state‐subsidized classrooms and found that, indeed, teachers have had

a positive effect on children’s language and literacy development.

Participating classrooms assessed children three times throughout the year; once in the fall (October),

winter (February), and spring (May). Teachers used the Individual Growth and Development Indicators

(IGDI’s) assessment tool to measure changes in three areas of early reading predictors (Picture

Naming, Rhyming, Alliteration), and also in the two skill areas of Letter Naming and Letter Sounds.

As the majority of students were dual language learners, many children were assessed in both English

and Spanish. In 2012‐13, there was an emphasis in all “SEEDS” classrooms on developing and improving

children’s vocabulary skills in English. Children whose primary language was Spanish were assessed using

the IGDI’s tool in both English and Spanish. Once children demonstrated proficiency in their scores on the

English‐language assessments, they did not continue taking the Spanish‐language assessments.

Results Because of the number of English‐language learners in these classrooms, there was interest in

focusing on the early literacy skills of children when assessed in their primary language. When

looking at the percentage of children who were proficient in the five pre‐literacy skill areas (scoring

“At” or “Above” target level), results showed that:

On average, children improved in all five pre‐literacy skill areas between their first (October)

and final (May) benchmark assessments.

37.7%28.3%

37.5%30.8%

45.1%

18.6%28.2% 32.8% 36.9%

45.0%

0%

20%

40%

60%

80%

100%

PictureNaming


LetterSounds

PictureNaming


LetterSounds







o When examining children in their primary language, Spanish‐speaking children made the

greatest improvements in Alliteration and Rhyming (they were not assessed in the Letter

Naming or Letter Sounds skill areas).




greater amount of improvement in Letter Sounds and Letter Naming, and equaled the

English‐speaking children’s amount of improvement in Rhyming and Alliteration.





Figure 91: Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012-2013)



Source: First 5 Santa Cruz County Early Literacy Foundations program records, Individual Growth and Development Indicators (IGDI’s) Assessment Tool, 2012‐2013. Children who completed at least (any) two benchmark assessments within a pre‐literacy skill area were included in the analysis of that skill.

* No Spanish assessments were analyzed in these two literacy skill areas, as they were not a requirement of these classrooms’ programs. N: See Ns for the following figure.

9.9% 6.9% 8.3%

22.1%15.1%

26.3%20.2% 19.9%

35.5% 34.6%36.6% 34.1%42.0%

48.8% 50.0%

0%

20%

40%

60%

80%

100%

Picture Naming Rhyming Alliteration Letter Naming Letter Sounds


7.8% 13.4% 17.1%

2.8% 2.0% 2.9% 4.8% 6.2%

21.7%

37.2%

49.1%

7.9% 11.4%

20.0% 20.5%28.8%

37.3%

56.5%

75.2%

21.3%30.1%

35.7%41.4%

51.1%

0%

20%

40%

60%

80%

100%

PictureNaming

Rhyming Alliteration LetterNaming*

LetterSounds*

PictureNaming


LetterSounds


English Assessment

English AssessmentSpanish Assessment



Figure 92: Amount of Increase in the Percentage of Children At/Above Targets for Later Reading Success, by Primary Language (2012-2013)


Tool, 2012‐2013. Note: Children who completed at least (any) two benchmark assessments within a pre‐literacy skill area were included in the analysis of that skill. * No Spanish assessments were analyzed in these two literacy skill areas, as they were not a requirement of these classrooms’ programs. English N= Fall: Picture Naming (223), Rhyming (159), Alliteration (144), Letter Naming (190), Letter Sounds (179). N= Winter: Picture Naming (240),

Rhyming (208), Alliteration (201), Letter Naming (200), Letter Sounds (182). N= Spring: Picture Naming (235), Rhyming (208), Alliteration (200), Letter Naming (201), Letter Sounds (186). Spanish/Spanish N= Fall: Picture Naming (180), Rhyming (134), Alliteration (129). N= Winter: Picture Naming (198), Rhyming (156), Alliteration (161). N= Spring: Picture Naming (169), Rhyming (154), Alliteration (153). Spanish/English N= Fall: Picture Naming (248), Rhyming (198), Alliteration (204), Letter Naming (229), Letter Sounds (225). N= Winter: Picture Naming (291), Rhyming (245), Alliteration (235), Letter Naming (219), Letter Sounds (212). N= Spring: Picture Naming (282), Rhyming (246), Alliteration (238), Letter Naming (232), Letter Sounds (231).

An analysis of the percentage of children who scored at each of the target levels (Below, Near,

At/Above), at both the first (October) and final (May) benchmark assessments, shows these results

in more detail. Because of the emphasis on developing and improving children’s vocabulary skills in

English, there was particular interest in analyzing the amount of improvement that children made in

their English abilities, which is highlighted in the following charts.

Figure 93: Percentage of Children at Each Target Level in Five Pre-Literacy Skill Areas, in English (2012-2013)

26.7% 27.2%33.7%

26.7%34.9%

29.5%

43.1%

58.1%

18.5%

28.1%32.8%

36.6%

44.9%

0%

20%

40%

60%

80%

100%

56.1%

23.0%

74.2%

34.6%

66.7%

38.0%

66.8%

35.8%

77.1%

40.3%

34.1%

40.4%

18.9%

31.3%

25.0%

20.0%

11.1%

15.4%

7.8%

9.7%

9.9%

36.6%

6.9%

34.1%

8.3%

42.0%

22.1%

48.8%

15.1%

50.0%

0%

20%

40%

60%

80%

100%


Below Near At/Above

Primarily English‐Speaking ChildrenEnglish Assessment


English Assessment


Spanish Assessment English Assessment

Benchmark


Rhyming Benchmark



Letter Sounds




Tool, 2012‐2013.



English N= Fall: Picture Naming (223), Rhyming (159), Alliteration (144), Letter Naming (190), Letter Sounds (179). N= Winter: Picture Naming (240), Rhyming (208), Alliteration (201), Letter Naming (200), Letter Sounds (182). N= Spring: Picture Naming (235), Rhyming (208), Alliteration (200), Letter Naming (201), Letter Sounds (186). Spanish/Spanish N= Fall: Picture Naming (180), Rhyming (134), Alliteration (129). N= Winter: Picture Naming (198), Rhyming (156), Alliteration (161). N= Spring: Picture Naming (169), Rhyming (154), Alliteration (153). Spanish/English N= Fall: Picture Naming (248), Rhyming (198), Alliteration (204), Letter Naming (229), Letter Sounds (225). N= Winter: Picture Naming (291), Rhyming (245), Alliteration (235), Letter Naming (219), Letter Sounds (212). N= Spring: Picture Naming (282), Rhyming (246), Alliteration (238), Letter Naming (232), Letter Sounds (231).

Santa Cruz Public Libraries – Read to Me Program

The Santa Cruz Public Libraries (SCPL) “Read to Me” program provides Read to Me Resource Kits for

parents and early childhood educators via library circulation to engage children and families in early

literacy activities. Geared for children 0‐5 years old, the kit is a blue canvas bag full of books and

activities, which can be checked out for four weeks. Each kit contains around 10 books, plus several of

the following items: felt stories, puppets, music cassettes (or CDs), and book on cassettes (or CDs).

In 2012‐13, funding was used to purchase materials for Read to Me Resource kits and for the new “Let’s

Play” science and math kits. “Let’s Play” kits are made for adults to use with their children ages 3‐8 years

old, either in child care settings or individual homes. However, all the kits use materials that parents and

caregivers can use with children of any age.

81.9%

32.6%

84.8%

33.3%

81.9%

37.4%

91.7%

39.7%

83.6%

33.3%

15.3%

46.1%

13.1%

36.6%

15.2%

26.9%

3.5%

19.0%

10.2%

15.6%

2.8%

21.3%

2.0%

30.1%

2.9%

35.7%

4.8%

41.4%

6.2%

51.1%

0%

20%

40%

60%

80%

100%


Below Near At/Above

Primarily Spanish‐Speaking ChildrenEnglish Assessment

Benchmark


Rhyming Benchmark



Letter Sounds

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ RAISING A READER


Raising A Reader

Program Description

Raising A Reader (RAR) fosters healthy brain development, supports parent‐child bonding, and

motivates families to read aloud with their children which helps develop the early literacy skills that

are critical for school success. Raising A Reader (RAR) began operation in Watsonville during the last

quarter of the 2005‐06 funding cycle. The program provides a way for children and their parents or

caregivers to participate in a weekly rotating

book bag program through early care and

education settings.

On a weekly basis, participating RAR

classrooms and family child care homes

provide children with bags that are filled with

various award‐winning books, which they

borrow and bring home to their parents. RAR

provides training and information to parents

and caregivers on how to effectively share

these books with their children at home, to

help develop their children’s early literacy

skills. RAR also connects families with their

local public library, and at the end of the

program children are given a book bag of their own as a way to encourage families to continue the

practice of borrowing and reading books together.

Population Served

New Existing

2012‐13Total

Children 3,615 1,055 4,670


Note: “New” children are those who began participating in Raising A Reader for the first time during this fiscal year. “Existing” children are those who began participating in Raising A Reader before this fiscal year, and continued their participation during this fiscal year.

Outcome Objective: Raising A Reader will support 210 sites

Periodically, Raising A Reader staff visit participating child care sites to monitor how well the

program is operating, and provide refresher books or trainings as needed. Indeed, as more and

more sites in the county have implemented RAR over the years, the objectives of RAR has shifted

from adding new sites to maintaining and supporting the existing ones.

“PVUSD Raising A Reader is most proud of the success in this community reaching out to families and providing access to books for young children.

Parents, teachers, providers, children, and librarians all over Santa Cruz and parts of Monterey sing praises of PVUSD Raising A Reader and give stories of how this program has touched their lives or benefited the community in some way.

Children are reaching for books, re-telling their favorite stories, and cuddling in the laps of a family member. Thank you for providing book access to those who need it the most.”

- Raising A Reader, Annual Progress Report

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ RAISING A READER


The following results show the number of sites that have been supported during the past year.

Some sites may be listed more than once if they required additional assistance throughout the year.

Type of Site

Number of Site Visits* 2012‐13

Total New Existing

Family Child Care Home 21 166 187

Preschool/Child Care Center 6 106 112

Total 27 272 299

Source: Raising A Reader/First 5 Santa Cruz County, 2012‐2013.

Note: The actual number of classrooms participating in Raising A Reader is likely to be higher than the total number of sites, as one site may include more than one classroom.

*Some sites may be visited more than once.

Outcome Objective: Parents will spend time reading or sharing books with their child

For the past several years, Raising A Reader distributed a Parent Retrospective Survey to the parents

participating in the program, which asked parents to report how often they performed certain

activities with their children before and after their participation in the RAR program. In 2012‐13, no

new survey was distributed, but instead a cumulative analysis of data from the previous four years

was performed (2009‐2012).

Results for the analysis of the last four years combined indicate that after participating in the RAR

program, almost twice as many parents read with their children three or more times per week,

compared to before they participated in RAR.

2009‐2012

BEFORE PARTICIPATING IN RAR PROGRAM

AFTER PARTICIPATING IN RAR PROGRAM

Percentage of parents who report reading with their child 3 or more times per week.

48% 88%

Source: Raising A Reader, Parent Retrospective Survey, 2012‐2013.

N: Client numbers were not reported for this cumulative analysis.

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ SUMMER PRE‐K ACADEMY


Summer Pre-K Academy

Program Description

Migrant Education implements a four‐week summer academy for children about to enter

kindergarten at seven Pajaro Valley Unified School District (PVUSD) elementary schools. The

program is for children who do not qualify for Migrant Education and who have little or no

preschool experience. The academy is geared toward exposing children to early literacy concepts

and kindergarten routines in a safe learning environment that helps to support children’s emotional

and social well‐being and build bonds with other children to ease later adjustments.

Population Served

2012‐2013

Children 116


Outcome Objective: Children will increase their recognition of letter sounds

Program Objectives

2012‐2013

All Children

Children attending at least

14 sessions

75% of participants who completed both the pre and post survey will increase their letter sound recognition by 5 letter sounds using the cognate alphabet in the child’s home language.

86.3%

N=102

87.4%

N=95

Source: Migrant Education – Summer Pre‐K Academy, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2013.

As seen in the following figures, students who participated in the Summer Pre‐K Academy made

tremendous gains in early literacy skills that are essential in kindergarten. On average, students

learned to recognize 15 new letter sounds after participating in this brief, yet focused program.

“One of the teachers shared the experience of one particular child that had never been to preschool and was very quiet and timid at the beginning of the program; he did not interact with any other students and did not participate in circle time activities.

By the end of the four week program this child had learned most of the letter sounds, he had learned how to count to 20, he learned the colors and geometric figures, and he had learned how to participate and interact with the other children. The Summer Pre-K Academy helped this child, and many like him, become confident and ready for success in kinder and beyond.”

- Migrant Education, Annual Progress Report

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ SUMMER PRE‐K ACADEMY


Figure 94: Summer Pre-K Academy Letter Sound Recognition Results (2013)

Percentage of Students who Increased Their Letter Sound Recognition By At Least 5 Letter Sounds

Average Number of Letter Sounds Recognized at Pre and Post Assessment

Source: Migrant Education – Summer Pre‐K Academy, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2013. N: (All Students) N=102. (14 or more sessions Students) N=95.

Results from past years show a consistent pattern of learning, with 71%‐93% of students increasing

their letter sound recognition by at least 5 letter sounds. Over the years, students have increased

their recognition of letter sounds by an average of 9 to 16 letter sounds.

Figure 95: Percentage of Summer Pre-K Academy Students who Increased Their Letter Sound Recognition By At Least 5 Letter Sounds

Figure 96: Average Increase in the Number of Letter Sounds Recognized by Summer Pre-K Academy Students

Source: Migrant Education – Summer Pre‐K Academy, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2007 ‐ 2013.

Note: Between 2006 and 2009, the Summer Pre‐K Academy was a 5‐week program. Beginning in 2010, it became a 4‐week program. Data for all years have been updated to reflect just the PVUSD school sites in Santa Cruz County, and exclude the two PVUSD sites in Monterey County.

N: (All Students) 2007=69, 2008=46, 2009=82, 2010=45, 2011=75, 2012=79, 2013=102. (14 or more sessions Students) 2009=65, 2010=31, 2011=67, 2012=72, 2013=95; no data for this population are available for 2007 and 2008.

86.3% 87.4%

0%

20%

40%

60%

80%

100%

All Students

Students who attended at least 14 sessions

2.7 2.8

17.5 17.8

0

5

10

15

20

All Students Students who attended atleast 14 sessions

Pre Post

84.1%76.1%

81.7%

71.1%

90.7%82.3% 86.3%

78.5% 80.6%

92.5% 87.5% 87.4%

0%

20%

40%

60%

80%

100%

2007 2008 2009 2010 2011 2012 2013

All Students Students who attended at least 14 sessions

14.2 13.3 13.1

9.4

16.3 15.714.713.7

10.8

16.0 16.415.0

0

4

8

12

16

20

2007 2008 2009 2010 2011 2012 2013

All Students Students who attended at least 14 sessions

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ CHILD SNAPSHOT


Transition to Kindergarten

Child Snapshot

Program Description

First 5 Santa Cruz County continued to support the use of the Child Snapshot as a vehicle for

communication among kindergarten, preschool and family child care teachers about children who

are transitioning from preschool to kindergarten. The Child Snapshot, developed in partnership

between kindergarten teachers and early childhood educators, is a three‐page form completed by

both the parent and the preschool teacher in the spring prior to kindergarten. The Snapshot

includes brief information about the child’s interests and abilities, language and developmental

concerns, preschool experience, and developmental information. Over the last few years the form

has been expanded to include additional information from parents such as family activities and

community supports for parents. A measurement of kindergarten readiness is also included at the

end of the Child Snapshot, using either the Desired Results Developmental Profile ‐ Revised,

Preschool (DRDP‐PS) or the Pre‐Kindergarten Observation Form (P‐KOF), depending upon the type of

preschool that children attended.

First 5 collects and delivers the completed Snapshots to the schools the children will be attending, at

which point they are routed to each child’s kindergarten teacher. The Child Snapshot supports

children’s transition to kindergarten by involving parents in the process and providing important

information that helps kindergarten teachers prepare for their incoming students.

Population Served

2012‐2013

Children 906


Information from the Child Snapshots provided the following portrait of children about to enter

kindergarten:

In Spring 2013, a total of 906 preschool children had Child Snapshots completed—453 boys

(51%) and 434 girls (49%) (19 students were missing data on gender).

These children were drawn from 40 preschool programs throughout Santa Cruz County and

their Child Snapshot forms were shared with kindergarten teachers at 53 elementary schools

in Santa Cruz County and surrounding areas.

The majority of children with Child Snapshots were Hispanic (76%), and 17% were Caucasian.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ CHILD SNAPSHOT


A slight majority of children with Child Snapshots spoke English as their primary language

(54%), followed closely by Spanish (43%).

A small percentage of parents and early educators reported that their children had various

health and academic challenges.

The majority of preschool children had received medical, dental, vision, and hearing

assessments in the past year, and 28% had received a developmental assessment.

Figure 97: Number of Child Snapshot Forms Collected from Participating Preschool Programs

Source: (2007‐2010) Applied Survey Research, Child Snapshot Log; (2011‐2012) Applied Survey Research, Portrait of School Readiness: Transition to Kindergarten—Child Snapshot; (2013) Applied Survey Research, Child Snapshot data report.

Figure 98: Demographics of Children with Child Snapshots

Ethnicity


N = 865.

Primary Language

Applied Survey Research, Child Snapshot data report, 2013.

N = 883.

393

889

617

832

976 942906

0

200

400

600

800

1,000

2007 2008 2009 2010 2011 2012 2013

76.0%

16.6%

7.4%

Latino

Caucasian

Other54.4%

42.6%

1.8% 1.2%

English

Spanish

Bilingual (English/Spanish)

Other



Figure 99: Percentage of Children With These Health and Academic Issues


* As described by child’s Early Educator.

**” Regularly” = more than twice a month but less than once a week; “Frequently” = at least one day per week.

*** IEP= Individualized Education Program; IFSP= Individualized Family Service Plan.

N: (Health problems)=848; (Language Progress)=865; (Absent)=864; (IEP/IFSP)=840; (Diagnosed need)=860.

Figure 100: Percentage of Children Who Received Health or Developmental Assessments in the Past Year


N: (Medical)=885; (Dental)=885; (Vision)=885; (Hearing)=885; (Developmental)=883.

Relationship Between Family Activities and Children’s School Readiness

In 2012‐13, a new analysis was performed to determine if any of the family activities noted in the

Child Snapshot were correlated with children’s school readiness skills, as measured by the DRDP‐PS.

The DRDP‐PS assesses children’s school readiness skills in four domains: 1) Self‐Care & Motor Skills,

2) Self‐Regulation Skills, 3) Social Expression Skills, and 4) Kindergarten Academics. Two separate

statistical analyses were conducted:

Correlation analyses were performed between parents’ frequency of engaging in an activity

and their children’s school readiness skills, and

Group comparisons were performed between parents who participated in a certain family

activity during a typical week, and those who did not engage in that activity, to see if there

were differences in their children’s school readiness skills.

11.7%7.2% 6.7% 6.1% 4.0%

0%

10%

20%

30%

40%

50%

Has Health Problems Child's Progress inPrimary Language is

"Delayed" *

Is "Regularly" or"Frequently" Absent**

Has an IEP or IFSP*** Has a Diagnosed SpecialNeed, Disability, orHealth Concern

86.3% 83.1%72.2% 68.6%

28.4%

0%

20%

40%

60%

80%

100%

Medical Dental Vision Hearing Developmental



Results from these two analyses revealed some statistically significant relationships between certain

family activities and school readiness outcomes.

Figure 101: The Impact of Family Activities on School Readiness

Kindergarten Academics

Family activities associated with greater readiness in the area of Kindergarten

Academics included:

Parents sang and told stories with children more times per week (N=376, r=.11, p<.05).

Parents reported eating family meals together more times per week (N=375, r=.11, p<.05).

Families visited the library (N=383, p<.05).

Self‐Care & Motor Skills

Family factors associated with greater readiness in the area of Self‐Care & Motor

Skills included:

Families drew, colored, painted, played with games and puzzles (N=385, p<.05).


Helping Kindergarten Teachers Get Prepared


In order to help collect data on how useful the Child Snapshots were in assisting with the

communication of information between early childhood educators and kindergarten teachers, a

new survey was conducted in January 2013 that asked kindergarten teachers for their feedback on

how they used the Child Snapshots that they received at the beginning of the 2012‐13 school year.

This confidential online survey21 was distributed to almost all kindergarten teachers and elementary

school principals at school sites that received Child Snapshots in 2012, asking each teacher if they’d

received any Child Snapshots, how they used these Child Snapshots, and whether and how they

were useful. Key results from this survey are provided below, which demonstrate the achievements

being made to bridge children’s transition to kindergarten.

21 See Appendix C for a description of this Child Snapshot Kindergarten Teacher Survey.



Survey Population

41 kindergarten teachers and 6 principals from 28 elementary schools completed the survey.

On average, there were 4 kindergarten classrooms in each elementary school.

37 respondents said they’d received Child Snapshots, and on average, these respondents said

they’d received Child Snapshots for 10 incoming kindergarteners.

Survey Results

Results from the Child Snapshot Kindergarten Teacher Survey indicated that 92% of kindergarten

teachers used them in some way to assist with their incoming students’ transition to kindergarten.

The Child Snapshot helped kindergarten teachers with three key transition elements:

Communication with parents.

o As noted previously, preschool and family child care teachers reviewed the Child Snapshot

together with parents as a way to review their children’s strengths and challenges.

o This exchange with the parents continued even after the Child Snapshot had been shared

with kindergarten teachers. Almost 22% of kindergarten teachers indicated that they used

the Child Snapshot to communicate with parents.

Preparation for the incoming students.

The information provided in the Child Snapshots helped Kindergarten teachers familiarize

themselves with each new student, which helped with welcoming the child and being

prepared for their individual needs from the very first day of the school year.

o Information from the Child Snapshot was used in many ways, including when concerns

arose (54%), to make decisions about groups within the classroom (41%), to communicate

with parents (22%), to tailor instruction (16%), to contact child’s former preschool teacher

(16%), to understand the child better (14%), and to form classes (8%).

o Almost 89% of Kindergarten teachers found the photograph of the child helpful, noting

that it helped them: recognize the children with they first met (46%), remember if the

child had attended the kindergarten registration event (15%), memorize the child’s name

(15%), remember key details about the child (15%), and gauge the child’s physical

development (8%).

o When asked if the summary of the child’s social and academic readiness skills was useful

(the DRDP‐PS or P‐KOF results), 50% of respondents said that they were “very useful” or

“extremely useful.”



Formation of balanced kindergarten classes.

o Many schools used the Child Snapshots to help form balanced classrooms. When asked

specifically if the Child Snapshots were used to help form their kindergarten classrooms

that year, almost 36% of teachers said “yes” or “somewhat.”

o Several of the kindergarten teachers mentioned that they received the Child Snapshots

after classrooms had already been formed, and asked to receive them earlier to help with

this process.

Figure 102: Responses to Key Questions from the Child Snapshot Kindergarten Teacher Survey

How did you use the information in the Child Snapshot? (Percentage of kindergarten teachers who chose each answer)

Source: First 5 Santa Cruz County, Child Snapshot Kindergarten Teacher Survey, 2013.

N = 37 respondents with 68 responses.

How useful was the summary of the child’s social and academic readiness skills on the last page of the Child Snapshot? (Number of kindergarten teachers who chose each rating)

Source: First 5 Santa Cruz County, Child Snapshot Kindergarten Teacher Survey, 2013.

N = 36.

Did your school use these Child Snapshots to help form this year’s kindergarten classrooms?

Source: First 5 Santa Cruz County, Child Snapshot Kindergarten Teacher Survey, 2013

N = 31.

54.1%

40.5%

21.6%16.2% 16.2%

13.5%8.1% 8.1% 5.4%

0%

10%

20%

30%

40%

50%

60%

Put into file andused when

concerns arose

To makedecisions aboutgroups withinthe classroom

Tocommunicatewith parents

To tailor myinstruction

Used to contactchild's formerpreschoolteacher

To understandthe child better

To form classes Never used Not applicableto me

2

6

10

14

4

02468

101214

Not at all useful(1)

Slightly useful(2)

Moderately useful(3)

Very useful(4)

Extremely useful(5)

12.9%

22.6%

64.5%

Yes

Somewhat

No

FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL ‐ TRANSITION TO KINDERGARTEN WORKSHOPS


Transition to Kindergarten Workshops

Program Description

Transition to Kindergarten Workshops are offered to families in preschool settings from January to

June of each year. These workshops inform parents about kindergarten registration requirements,

choices of language programs, how to support their child in school, and ways to ensure that their

child’s entry into school is a pleasant and smooth transition.

Families participated in workshops at 15 State and Federally funded Preschool sites throughout the

county.

Population Served

2012‐2013


Source: Transition to School – Workshop Schedule and Participant Data, 2012‐2013.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL ‐ TRANSITION TO KINDERGARTEN WORKSHOPS


FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT APPENDICES


APPENDICES

APPENDICES FIRST 5 SANTA CRUZ COUNTY 2012‐2013 ANNUAL EVALUATION REPORT




Appendix A: First 5 Santa Cruz County Strategic Framework

The First 5 Santa Cruz County Strategic Plan for 2012‐2015 refines the strategic framework that it

first developed in 2005, and further refined in 2009. The following diagrams illustrate the focus

areas, results, and strategies in which the Commission chose to invest between 2012 and 2015.

Focus Area

Results

Strategies

Increase number of children reaching

developmental milestones

Increase use of preventive health care

Increase insurance coverage

Increase medical /

dental homes

Outreach, enrollment, retention, and utilization through a county‐

led outreach coalition with community‐based CAAs

Coordination through staffing support of Healthy Kids

collaborative

Scholarship support for

Healthy Families premiums

Funding of Healthy Kids premiums

Neurodevelopmental clinic for young

children entering child welfare services

Support for developmental

screening

Focus Area

Results

Strategies

Decrease child abuse and neglect

Improve parent and caregiver practices that support

social/emotional development

Differential response home visiting for families referred to child welfare but not meeting the threshold of abuse and neglect

Implement evidenced‐based public health approach to

parent education and support

Early mental health

consultations

Strong Families

Healthy Children



Focus Area

Results

Strategies

Increase the quality of early learning

programs

Improve early literacy skills

Family Friendly Integrated Services

Pilot local quality

improvement and rating system

Support summer academy for children

who have not experienced preschool

Implement model

infant/toddler quality site

Implement early literacy professional development strategies

Support transition to kindergarten practices

Focus Area

Strategies Training, shared data, community

events, and capacity‐building projects

Assist with staffing other community events aligned with First 5’s strategic plan

Co‐sponsor (fund) projects or initiatives

that promote integrated services


Expansion of family book

access programs

Increase early literacy and English language

skills in state preschool classrooms



Appendix B: Race to the Top – Quality Continuum Framework: Hybrid Matrix



Appendix C: Measurement Tools

The following assessments and measurement tools were used to collect evaluation data during this

funding cycle. They are listed in alphabetical order.

Ages & Stages Questionnaires (ASQ)

The Ages & Stages Questionnaires® (ASQ) are used to screen infants and young children for

developmental delays during the crucial first five years of life. Parents complete the 30‐item

age‐appropriate questionnaires at designated intervals, assessing children in their natural

environments to ensure valid results. Each questionnaire covers five key developmental

areas: communication, gross motor, fine motor, problem solving, and personal‐social.22

Bayley Scales of Infant and Toddler Development, 3rd Edition

The Bayley Scales of Infant and Toddler Development is a standardized test that was used by

the Neurodevelopmental Clinic (Dominican Interdisciplinary Child Development Program) to

assess children’s developmental skills in the areas of cognition, language, and motor skills.

There are also additional measures of adaptive skills and emotional functioning. The

instrument is used for children from ages 16 days to 42 months. Standard scores have a

mean of 100 and standard deviation of 15.

Child/Home Early Language and Literacy Observation Tool (CHELLO)

Child/Home Early Language and Literacy Observation (CHELLO) is a tool designed to rate the

early literacy environment in home‐based child care settings of children ages birth to 5 years.

The CHELLO was used to develop accurate profiles of materials and practices in family/group

child care settings, improve early childhood educator literacy supports and interactions with

children, and measure changes in the quality of environments over time.

The CHELLO tool was used by the Early Literacy Foundations, and assessed home‐based

classrooms using the Literacy Environment Checklist, and along the three dimensions of the

Group/Family Observation section: Physical Environment for Learning, Support for Learning,

and Adult Teaching Strategies.

Child Behavior Checklist (CBCL)

The Child Behavior Checklist (CBCL; Achenbach, 1991; 2001) is part of the Achenbach System

of Empirically Based Assessment. The CBCL is a screening tool which is used by parents (and

in mental health settings) to assess behavioral and emotional problems in children and

adolescents (this is only completed if the child is aged 18 months or older).

The Child Behavior Checklist (CBCL) contains about 100 items that can cluster into several

syndromes, competence scales, and codes from the Diagnostic and Statistical Manual of

22 Brookes Publishing, Ages & Stages Questionnaires® (ASQ), http://www.brookespublishing.com/store/books/bricker-asq/, 2007.



Mental Disorders, 4th Edition (DSM‐IV). Children are ranked according to the severity of

behavior, thus percentile rankings tell us how a child, or group of children, compare to the

general population. Higher percentile rank indicates more problematic behavior. Rankings

falling between the 65th and 70th percentile indicate “Borderline Clinical”; the 70th

percentile rank and above denote the clinical range. Clients who score at or near the clinical

range are more likely to have or develop a clinical diagnosis. Thus, the CBCL serves as an

indicator of clinical risk based on the degree of similarity with other children who have

received (or have not received) a diagnoses. A significant drop in percentile rank indicates a

decrease in clinical risk.

The CBCL has good psychometric properties and has been validated internationally. This tool

is helpful in determining children who might benefit from additional assessment and mental

health services.

Child Snapshot

The Kinder Transition Team Child Snapshot was a strategy within the Transition to School

Plan and was identified by the Transition to School Advisory group in July 2005 as one that

could help support children’s adjustment to kindergarten. The Snapshot is completed by

parents and early care teachers for each child entering kindergarten in the fall, and is

forwarded on to the child’s new kindergarten teacher. The form includes brief (snapshot)

information about the child’s interests and abilities, the child’s health, language or

developmental concerns, preschool experience, and other developmental information. The

form was expanded in 2009‐10 to include additional information such as family activities and

community supports for parents. A measurement of kindergarten readiness is also included

at the end of the Child Snapshot, using either the Desired Results Developmental Profile‐R

Preschool or the Pre‐Kindergarten Observation Form, depending upon the child care site

within Santa Cruz County (both of these assessments are described in this Appendix).


The Child Snapshot Kindergarten Teacher Survey was designed to collect data on how useful

the Child Snapshots were in assisting with the communication of information between early

childhood educators and kindergarten teachers. This new survey was conducted in January

2013, and asked kindergarten teachers for their feedback on how they used the Child

Snapshots that they received at the beginning of the 2012‐13 school year.

This confidential online survey was distributed to almost all kindergarten teachers and

elementary school principals in the County via email. The survey included 22 questions that

asked about their job title and about their elementary school, if they’d received any Child

Snapshots, how they used these Child Snapshots, and whether and how they were useful. It

included 22 questions and took approximately 5‐10 minutes to complete. As an incentive to

participate, respondents were told they could receive a $5 gift card for either Santa Cruz

Coffee Roasting Company or Starbucks if they completed the survey.



To encourage honest answers to the survey questions, the online survey was administered by

an independent consultant, who explained to the respondents that their participation would

remain anonymous to First, and that all their survey results would be presented to First 5 in a

way that did not identify specific respondents. Respondents who requested the $5 gift card

were assured that First 5 would only see their names and addresses (so that the cards could

be mailed out to them), and that First 5 would not be able to connect their name with their

survey responses.

Classroom Assessment Scoring System™ (CLASS™)

The Classroom Assessment Scoring System™ (CLASS™) is an observational instrument used by

the Quality Early Learning Initiative to assess classroom quality in Pre‐K classrooms. The

CLASS™ instrument measures teacher‐student interactions in a classroom setting and offers

resources for strengthening those interactions across any subject area or age group. It

includes four cycles of 15‐minute observations of teachers and students by a certified

CLASS™ observer. Those observations are then rated using a manual of behaviors and

responses.

Conflict Behavior Questionnaire

The Conflict Behavior Questionnaire (CBQ) was utilized by clients participating in the Teen

variant of Levels 4 and 5 of the Triple P Program. It is a 20‐item true/false scale that assesses

general conflict between parents and their children. The CBQ was completed by both parents

and adolescents, and discriminates between distressed and nondistressed families.

This 20‐item measure contains both “positive” and “negative” statements regarding a child’s

social competence/conflictual behaviors. Items are rated by selecting either a 1 (true) or

2 (false). To obtain an overall measure of social competence, “false” items are recoded to a

value of 1, while “true” responses are recoded to a value of 0. Then all 20 items are summed

to obtain an overall score and measure of conflictual behaviors, with scores ranging from 0

(non‐distressed) to 20 (distressed). A non‐zero score indicates some conflictual behaviors; a

high score indicates a great amount of conflict.

Depression, Anxiety, and Stress Scale (DASS-21)

The Depression, Anxiety, and Stress Scale – Short Version (DASS‐21) was utilized by

participants in Levels 4 and 5 of the Triple P Program. It is a 21‐item brief version of the

Depression Anxiety Stress Scales (Lovibond & Lovibond in 1995). It is a self‐report measure

used to assess the levels of depression, anxiety, and tension/stress experienced, which was

completed by parents in the program. Respondents indicated how much they felt each of the

21 symptoms during the previous week. The scale is psychometrically sound – it has good

convergent and discriminant validity. It also has high internal consistency in clinical and non‐

clinical samples, and across different ethnic groups.



Desired Results Developmental Profile (DRDP)

The Desired Results Development Profile was created as a comprehensive program evaluation

system designed to measure California Department of Education funded child development

program effectiveness. Desired Results reflect the positive effects of the state‐funded child

development system on the development and functioning of children and on the self‐

sufficiency and functioning of families23. The DRDP is an observation‐based assessment and is

organized into several domains, each representing a crucial area of learning and

development. Each domain contains several measures, which focus on a specific competency

within that domain. There are three DRDP assessment instruments: infant/toddler (birth to

36 months), preschool (three years to kindergarten entry), and school‐age (kindergarten

through 12 years); two of these assessments were used by First 5 partners:

a) Desired Results Developmental Profile – Infant/Toddler (2010)

The DRDP – Infant/Toddler (2010) is used for children ages birth to 36 months, and measures

five domains. The Starlight Children’s Center chose to assess the infants and toddlers

participating in their program in two domains, using a total of eight measures. In the Self and

Social Development domain, two measures were used to assess interactions and

relationships with adults. In the Language and Literacy Development domain, six measures

were used to assess language comprehension, communication skills, interest in literacy, and

recognition of symbols.

b) Desired Results Developmental Profile - Revised, Preschool (DRDP-R, PS)

The DRDP – Preschool Version is used for children 3 years of age to kindergarten entry. The

DRDP‐PS has 10 overall indicators, containing 39 measures. This version of the DRDP

instrument was used in conjunction with the Child Snapshot (see Child Snapshot).

Early Language and Literacy Classroom Observation Pre-K Tool (ELLCO Pre-K)

The first version of the ELLCO (ELLCO Toolkit) was designed to evaluate the teaching practices

of early childhood educators in the areas of language and literacy, in pre‐kindergarten to

third‐grade classrooms.24 The newest version of the tool (ELLCO Pre‐K) is comparable to the

ELLCO Toolkit, and has been reorganized so that it reduces the bias towards classrooms that

have a lot of resources, and focuses more on the use of materials rather than just their

presence in the preschool classrooms.25

The ELLCO Pre‐K was used by the Early Literacy Foundations to help identify the effectiveness

of classroom teaching on children’s language and literacy development by focusing on five

23 California Department of Education. (2009). Introduction to desired results. Retrieved from http://www.cde.ca.gov/sp/cd/ci/desiredresults.asp

24 Education Development Center, Inc., Center for Children and Families, Early Language and Literacy Classroom Observation Toolkit, 2002.

25 Review by Maria Cahill (University of Tennessee), of the User’s Guide to the Early Language & Literacy Classroom Observation Pre‐K Tool, Education Book Review website.



components: “Classroom Structure,” “Curriculum,” “Language Environment,” “Books and

Book Reading,” and “Print and Early Writing.” Items are scored along a 5 point scale, where 1

is deficient and 5 is exemplary. From this scale, early childhood educators’ classroom scores

can be categorized into three levels of support for language and literacy, indicating their

classroom environment provides either Low‐Quality Support (with means less than or equal

to 2.5), Basic Support (with means between 2.51 and 3.5), or High‐Quality Support (with

means between 3.51 and 5).

Eyberg Child Behavior Inventory Intensity Scale (ECBI)

The Eyberg Child Behavior Inventory Intensity Scale (ECBI; Eyberg & Pincus, 1999) was utilized

by participants in Levels 4 and 5 of the Triple P Program (this was only completed if the

parent had at least one child aged 18 months or older). The ECBI is a 36‐item parent report

measure of behavior problems among children. Parents indicate the frequency of common

behavior problems, such as wetting the bed, whining, or having temper tantrums. Parents

indicate how frequently each of the problem behaviors occur (from never to always) and

whether or not they feel that the behavior is a problem (yes or no). The ECBI has good

psychometric properties (reliability and validity). The ECBI is useful in determining children

that may have a diagnosable disruptive behavior disorder, as well as for helping intervene to

reduce early behavior problems and to reduce negative parent‐child interactions that may

contribute to the development of disruptive behavior problems.26

Healthcare Effectiveness Data and Information Set (HEDIS) Indicators

First 5 uses the Healthcare Effectiveness Data and Information Set (HEDIS) data to track the

quality of care that children enrolled in Healthy Kids are receiving in Santa Cruz County.

Selected health care quality indicators are requested annually by First 5 California and the

California Endowment from every operating Healthy Kids insurance plan based on data

entered into HEDIS. HEDIS is a “set of standardized performance measures designed to

ensure that purchasers and consumers have the information they need to reliably compare

the performance of managed health care plans.”27

Individual Growth and Development Indicators (IGDI’s)

Individual Growth and Development Indicators (IGDI’s) are a set of measures designed and

validated for use by early education professionals for the purpose of monitoring children’s

growth and progress in early reading predictors. Unlike standardized tests that are

administered infrequently, IGDI’s is designed to be used repeatedly by early childhood

educators in order to estimate each child’s “rate of growth” over time. The distinctive benefit

of this approach is that the information can be used to directly inform intervention design,

implementation, and modification at reasonable levels of training, time, and cost. The tools

26 Berkovits, M. D., O’Brien, K. A., Carter, C. G., & Eyberg, S. M. (2010). Early identification and intervention for behavior problems in primary care: A comparison of two abbreviated versions of parent‐child interaction therapy. Behavior Therapy, 41, 375 – 387.

27 National Committee for Quality Assurance (NCQA), Guidelines for Advertising, Retrieved from http://www.ncqa.org/, 2012.



provide helpful information about children’s growth in three key areas of reading predictors:

Picture Naming (a measure of vocabulary development), Rhyming, and Alliteration.

Beginning in 2012‐13, there was a change in the method used for determining each child’s

primary language, which was now directly noted by the teacher. Children noted as bilingual

(English/Spanish) were included in the “Primarily English‐Speaking” analyses. Although the

previous method of determining primary language was highly accurate, this new method was

introduced to ensure complete precision.

Migrant Education Even Start (MEES) Pre-K Letter Sound Identification

Children attending the Migrant Education Summer Pre‐K Academy are assessed using the

Pre‐K Letter Sound Identification tool, which is used to assess letter sound recognition in the

child’s primary language. The MEES tool is a pre‐ and post‐program survey that allows early

childhood educators to circle those letters for which the child can say the sound (not the

name of the letter). Changes in children’s outcomes are evaluated by comparing the scores

between their baseline and final assessments.

New Portage Guide: Birth to Six

The New Portage Guide: Birth to Six is a developmental assessment tool based on direct

observations of typical milestone skills in five domain areas, rated as either: No/Not

observed, Occasionally/Emerging Skill area, or Consistently/Mastered. “Mastery” of an

indicator means that the child consistently demonstrates the skill in a variety of settings.

Assessments are completed three times a year for each child to document their growth and

development, measure progress and plan individualized activities.

Parent Problem Checklist

The Parent Problem Checklist (PPC; Dadds & Powell, 1991) was utilized by Levels 4 and 5 of

the Triple P Program. It is a 36‐item self‐assessment measure of parental and relationship

conflict, completed by each parent (or each adult who is co‐parenting the child). For each

issue (e.g., disagreement over household rules), parents identify if the issue has been a

problem (yes or no), and the extent to which the issue has been a problem, from not at all, to

very much. It has been shown to have high internal consistency, test‐retest reliability, and

convergent validity.

In 2012, two questions from the Parenting Experience Survey (PES) were added to the end of

this assessment that asked additional questions about the parent’s relationship with the co‐

parenting adult, allowing a more robust analysis of Triple P participants’ relationship issues.

Parenting Experience Survey

The Parenting Experience Survey (Sanders et. al., 1999) was utilized by Level 3 of the Triple P

Program. It is a self‐report measure of issues related to being a parent, and was completed

by parent participants. It consists of 7 items and assesses parents’ experiences related to



issues such as how difficult they perceive their child to be, how stressful they feel parenting

to be, and how rewarding they feel parenting to be. There are 3 items which are specific to

parents who have a partner. Those items are used to assess agreement on discipline, partner

support, and relationship happiness. This survey has been used to show changes in parental

attitudes and behaviors from the beginning to the completion of the Triple P Program.

Parenting Scale

The Parenting Scale (Arnold, O’Leary, Wolff & Acker, 1993) was utilized by clients in Levels 4

and 5 of the Triple P Program, as part of the general “Core” variant of program (this was only

completed if the parent had at least one child aged 18 months or older). It is a measure of

parenting styles for handling child misbehavior, completed by parents. It consists of 30 items,

which are grouped into 3 factors: laxness, over‐reactivity, and hostility (some items are not

part of any factor, and are called “No Factor” items). Clinical cut‐off scores have been

evaluated for all three factors and the overall score, which determine whether a client is at a

level of clinical concern in those areas. The Parenting Scale has good test‐retest reliability,

discriminant validity, and correlates with other self‐report measures of child behavior,

marital discord, and child behavior.

For clients who are participating in the “Teen” variant of the Triple P Program, there is a

“Teen” version of the scale that consists of 13 items that are grouped into 2 factors: laxness

and over‐reactivity (one item is not part of any factor, and is called a “No Factor” item). All of

the questions in this Teen variant of the scale are also part of the scale used in the Core

variant. Unlike the Core version, however, no clinical cut‐off scores have yet been evaluated

by the developers of this tool, for either of the two Teen factors or for the Teen overall score.

In 2012, modifications were made by First 5 Santa Cruz County to the Core Parenting Scale to

accommodate the launching of the “Teen” variant of the Triple P program. This modified

scale incorporates all of the “Teen” items, and all of the “Core” items that constitute one of

the 3 factors. Core items that were not part of any factor (“No Factor” items) were omitted.

Because all of the Teen items were also part of the original Core scale, these changes

reduced the total number of items in the modified scale from 30 to 17. This one modified

scale was designed to be filled out by clients in both the Teen and Core variants, and the

appropriate items would be used to calculate the factors and overall scores specific to that

variant.

The impact of these modifications on the original Core version was minimal, with all three

Core factors still containing the same items, and all factors using the same clinical cut‐off

scores. However, the Core overall score will be calculated differently since many of the “No

Factor” items were omitted. Therefore, the clinical cut‐off score for the Core overall score is

no longer appropriate, and caution should be used when comparing the Core overall score to

previous years’ overall scores.



Parent’s Attribution for Child’s Behavior Measure

The Parent’s Attribution for Child’s Behavior Measure (Pigeon & Sanders, 2004) was utilized

by Level 5 Pathways of the Triple P Program (this was only completed if the parent had at

least one child aged 18 months or older). It is a self‐report measure of attributions for

children’s behaviors. The instrument consists of 6 hypothetical situations describing different

types of difficult child behavior, with 4 questions related to each situation. The questions for

each situation relate to innateness of the child’s behavior, the child’s intentionality, and the

blameworthiness of the child. The total score and the 3 subscale scores for this tool have

good internal consistency and discriminant validity.

Pre-Kindergarten Observation Form (P-KOF)

The Pre‐Kindergarten Observation Form (P‐KOF) was originally developed by Applied Survey

Research in 2001 using guidelines from the National Education Goals Panel (NEGP)

framework of readiness. Since 2001, four additional skills have been added to better capture

children’s skills at negotiation, coping, empathy, and handling frustration. The P‐KOF is a 24‐

item, observation‐based assessment used by child care providers to assess children on

readiness skills pertaining to kindergarten academic skills, social expression, self‐regulation,

and self‐care and motor skills. Child care providers were asked to observe and score each

child according to his or her level of proficiency in each skill, ranging from not yet to

proficient (with an option of don’t know/not observed for each item). The P‐KOF has been

shown to have good reliability and validity. The instrument was attached to the back of the

Child Snapshot, and was utilized at certain sites within Santa Cruz County.

Raising A Reader: Parent Impact Survey

The Parent Impact Survey is utilized by the Raising A Reader Program. It is a self‐report

measure of parent and child engagement with books and library use. It consists of 29 items

related to reading in the home, use of book bags, and parent‐child reading practices. Items

assess current practices but there are also retrospective items which assess parent and child

reading practices before program participation.

Santa Cruz County Services Unifying Network (SCC SUN) Database / CCD Data

Funded partners were required to submit information on a biannual basis on the program

participants who they directly served. Client characteristic data (CCDs) were gathered in one

of two ways, the SCC SUN database, and partner‐specific data collection forms.28

o The SCC SUN database was launched on January 1, 2004, and some partner agencies used

this database to record their clients’ data. The database was integrated, meaning that

information could be shared between agencies, if the appropriate consent was obtained.

28 In this report, all client characteristic data (CCDs) collected from both the SUN database and partner‐specific data collection forms, that were then combined and comprehensively analyzed, are collectively referred to as “SUN database/CCD data.”



Demographic information about these clients could then be extracted for analysis, using

unique IDs that maintained clients’ anonymity.

o Partner agencies not using the SCC SUN database collected and submitted demographic

data in partner‐specific data collection forms.

In the course of evaluating these data, a “cleaning” process was performed. In this process,

each program’s data were standardized to use the same response sets, reviewed for accuracy

and completeness, and corrected wherever possible. These data were then migrated to a

customized statistical database that aggregated them and determined the unduplicated

count of individuals served by goal area, partner agency, and overall. Each client

characteristic was analyzed, with results that reported the total number of individuals with

data for that variable, and the frequency and percentage of each response to that variable.

o Children’s ages were determined in these ways:

For all partners except Triple P, children’s ages were calculated as of the first day of the funding cycle. This enabled all children ages 0‐5 to be included in the analyses, even if they turned six years old later in the year. Children not yet born by the first day of the funding cycle (i.e., born later in the funding cycle) were also included in the analyses and categorized as being under one year of age.

For Triple P children, their ages were calculated as of the date of their parent’s first assessments (“Pre‐assessments”), or the date of their single program session. This date was chosen since many Triple P assessments required that the child be within a certain age range for the parent to complete it. Therefore, this more exact determination of the child’s age as of the date of the assessment was needed in order to identify whether or not it was appropriate to include those data in the analysis of that assessment.

o The cities where clients lived were organized into the following sub‐county areas:

SUB‐COUNTY AREA CITIES

North County Bonny Doon, Capitola, Davenport, Live Oak, Santa Cruz, Scotts Valley, Soquel

South County Aptos, Corralitos, Freedom, La Selva Beach, Seacliff, Watsonville

San Lorenzo Valley Ben Lomond, Boulder Creek, Brookdale, Felton, Mount Hermon

Structured Decision Making (SDM)

The Structured Decision Making (SDM) model is a set of assessments for guiding decision‐

making at each of the decision points for children in Families Together. One assessment is the

SDM Family Prevention Services Screening Tool (FPSST), used to make two decisions:

whether or not to offer voluntary prevention services and, if so, the frequency of ongoing

case manager contact. The screening tool identifies families who have low, moderate, high,

or very high probabilities of future abuse or neglect. The risk level identifies the degree of risk



of future maltreatment, guides the decision to offer voluntary prevention services, and helps

determine the frequency of case manager contact.

The SDM:FPSST is also used to reassess a family in order to make two decisions: whether or

not to continue voluntary prevention services past 12 months for these families receiving

intensive services, and past 3 months for those receiving a brief intervention and, if so, the

frequency of case manager contact.29

Triple P Satisfaction Survey

Multiple Sessions (Individual or Group)

The Multiple Sessions Satisfaction Survey was utilized for parents who completed

Levels 3 (Individual /Brief Group), 4, or 5 of the Triple P Program. It consists of 16 items:

13 closed‐ended items and 3 open‐ended items. Parents assessed many different dimensions

of the program including: the quality of the program, the extent to which the program met

their needs and their child’s needs, how much the program helped parents deal with

problems in their family or with their children, relationship improvement, child behavior

improvement, and overall satisfaction.

Single Sessions (Seminars & Workshops)

The Single Session Satisfaction Survey was utilized for parents who participated in Level 2

Seminars and Level 3 Workshops of the Triple P Program. It consists of 4 items: 3 closed‐

ended questions, and 1 open‐ended question. Participants filled out this short survey which

assessed if they felt that the Seminar or Workshop addressed their questions, whether they

were going to use any of the parenting strategies they learned, and if they were satisfied,

overall, with the Seminar or Workshop. Participants could also add any additional comments

they had. Late in fiscal year 2011‐12 an additional question was added that asked

participants how they first heard about the program, and in 2012‐13 participants had the

option of providing their email address if they were interested in receiving the Triple P

newsletter.

Wechsler Preschool and Primary Scales of Intelligence, 4th edition (WPPSI-IV)

The WPPSI IV was used by the Neurodevelopmental Clinic (Dominican Interdisciplinary Child

Development Program), and is an individually administered test designed to reflect the

cognitive functioning of young children, with two bands available: one for children ranging in

age from 2 years, 6 months to 3 years, 11 months, and another for children ranging in age

from 4 years to 7 years, 7 months (to accommodate the substantial changes in cognitive

development that occur during early childhood). The test yields three levels of interpretation:

Full Scale, Primary Index scale, and Ancillary Index scale levels. A full scale composite IQ is

also calculated. Standard scores have a mean of 100 and standard deviation of 15.

29 Children’s Research Center, Structured Decision Making Policy and Procedure Manual, 2006.

2012-13 annual evaluation report - first 5...

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