SULZBERGER DISTINGUISHED LECTURE VISIT

Duke Center for Child and Family Policy

March 20, 2018

It will be seen that I have endeavored

to make provision in some measure

for the needs of mankind

along physical, mental and spiritual lines.

JAMES BUCHANAN DUKE

Indenture of Trust

STRENGTHENING LIVES AND COMMUNITIES BY…

PROMOTING HEALTH

NURTURING CHILDRENEDUCATING MINDS

ENRICHING SPIRITS

STRENGTHENING LIVES AND COMMUNITIES BY…

EXAMPLES OF MODIFICATIONS

EARLY CHILDHOOD

Birth to 3rd Grade

DEVELOPMENT ACROSS THE CHILD’S LIFESPAN

10

FIRST YEAR OF LIFE

-8 -7 -6 -5 -4 -3 -2 -1 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Prenatal (months) Year 1 (months) Years 1-18

Sensory Pathways(Vision, Hearing)

LanguageHigher Cognitive Function

Source: C.A. Nelson (2000)

NURSE-FAMILY PARTNERSHIP

Research-based home visiting

program that helps first time, low

income mothers

• 3 Randomized Control Trials

• Longitudinal data (1970s)

• Improved outcomes for

Mother and Child

COLLABORATION TO EXPAND NURSE-FAMILY

PARTNERSHIP

Blue Cross Blue Shield Foundation

Kate B. Reynolds Foundation

NC Division of Public Health

Local County Smart Start agencies

(e.g., Rockingham County)

Blue Cross Blue Shield Foundation

SC Carolina First Steps

(State & Local, e.g. Greenville)

SC Children’s Trust Fund

The Boeing Company

SC Dept. of Health & Human Services

FEDERAL FUNDING

Maternal, Infant & Early Childhood Home Visiting (MIECHV)

NURSE-FAMILY PARTNERSHIP

*

Union

Lee

Anderson

Berkeley

Charleston

Darlington

Dorchester

Florence

Greenville

Horry

Kershaw

Lexington

Newberry

Oconee

Richland

Spartanburg

York

Beaufort

Abbeville

Allendale

BambergBarnwell

Chesterfield

Clarendon

Dillon

Edgefield

Fairfield

Greenwood

Hampton

Lancaster

Laurens

Marion

McCormick

Orangeburg

Williamsburg

Aiken

Calhoun

Chester

Colleton

Georgetown

Jasper

Pickens

Saluda Sumter

Cherokee

CurrituckAlleghany

Anson

Bertie

Bladen

Burke

Caldwell

Camden

Caswell

Clay

Cleveland

Columbus

Cumberland

Duplin

Gates

Graham

Greene

Halifax Hertford

Hyde

Jones

Lenoir

Martin

McDowell

Mitchell

Montgomery

Northampton

Richmond

Robeson

Rockingham

Rutherford

Scotland

Surry

Tyrrell

Vance

Warren

Washington

Wayne

Wilson

Yancey

AlamanceAlexander

Ashe

Avery

Catawba

Chowan

Craven

DareDavidson

Davie

Gaston

Granville

Harnett

Hoke

Jackson

Macon

Madison

Nash

Onslow

Pamlico

Pasquotank

Pender

Perquimans

Person

Pitt

Polk

RandolphRowan

Sampson

Stanly

Stokes

Swain

Transylvania

Watauga WilkesYadkin

Beaufort

Cherokee

Lee

Brunswick

Buncombe

Cabarrus

Carteret

Chatham

Durham

ForsythFranklin

Guilford

Haywood

Henderson

Iredell

JohnstonLincoln

Mecklenburg Moore

New Hanover

Orange

Union

Wake

Edgecombe

Marlboro

24 Counties in North Carolina

28 Counties in South Carolina

CHILD

CARE

HIGHER

EDUCATION

HEALTH

CARE

RURAL

CHURCH

Fewer Children

In Welfare System

A More Educated

Society

Healthier

Population

Stronger

Communities

CHILD

CAREStrong

Children &

Families

Healthy

Start

Academic

AchievementEngaged

Congregations

Fewer Children

In Welfare System

A More Educated

Society

Healthier

Population

Stronger

Communities

HIGHER

EDUCATION

HEALTH

CARE

RURAL

CHURCH

TRENDS IN

PHILANTHROPY

TRENDS IN PHILANTHROPY

• Focus on data, evidence and impact

• Collaboration with other funders

• Working with government

• Longer-term commitment

• Place-based investments

TRENDS IN PHILANTHROPY

• Focus on data, evidence and impact

• Collaboration with other funders

• Working with government

• Longer-term commitment

• Place-based investments

Job Training Partnership Act: Impact on

Earnings of Male Youth (Non-arrestees)

Program group

Job Training Partnership Act: Impact on

Earnings of Male Youth (Non-arrestees)

Program group

Control group

Typical Outcome Metrics Often Yield

Erroneous Conclusions about Program

Effectiveness

Adult outcomes for individuals who participated in an

early childhood education program:

• 35% didn’t finish high school or complete a GED

• 32% had been detained or arrested

• 57% of females had out-of-wedlock births

• 59% received gov’t assistance (e.g., welfare)

Was this program effective?

Outcomes compared to the control group

show large positive effects

Impact of Perry Preschool Project on life outcomes:

3532

57 5955

48

8380

0

10

20

30

40

50

60

70

80

90

100

Did Not Complete

High School

Detained or Arrested Pregnancy Out-of-

Wedlock

Received

Government

Assistance (e.g.

welfare)

Treatment

Control

ENDOWMENT-WIDE EXAMPLES

Clergy Health(Rural Church)

Benchmark Quality

(Healthcare)

Gallop Surveys(Furman Univ.)

Evidence-based parenting programs(Child Care)

TRENDS IN PHILANTHROPY

• Focus on data, evidence and impact

• Collaboration with other funders

• Working with government

• Longer-term commitment

• Place-based investments

BLUE MERIDIAN PARTNERS

Goal:

Replicate/expand reach of

effective programs for

disadvantaged children and

youth

CAPITAL AGGREGATION

• Collaboration with national/regional foundations

• Edna McConnell Clark Foundation

• George Kaiser Family Foundation

• The Duke Endowment

• Five individual philanthropists

• More than $1 billion investment

TRENDS IN PHILANTHROPY

• Focus on data, evidence and impact

• Collaboration with other funders

• Working with government

• Longer-term commitment

• Place-based investments

Scale proven intervention

Agree upon outcome targets

Calculate resulting

cost savings

Evaluate

Targets met?

Government reinvests

Escrowed$7.5 M

• 4,000 first-time, low income mothers

• Preterm deliveries (13.5% )

• Childhood injuries (23.4%)

• Subsequent pregnancies (18%)

Randomized Control Trial

SC NURSE-FAMILY PARTNERSHIP: PAY-FOR-SUCCESS

• 65% from 200 lowest income zip codes

• Raised: $38M

TRENDS IN PHILANTHROPY

• Focus on data, evidence and impact

• Collaboration with other funders

• Working with government

• Longer-term commitment

• Place-based investments

Support is appreciated from The Duke Endowment; the Durham, NC, County Commissioners;

the North Carolina Department of Health and Human Services; the Pew Center on the

States; the Laura and John Arnold Foundation; NIDA; and NICHD.

Contact: Kenneth Dodge, dodge@duke.edu

• Population rates of child abuse and neglect are too high

• In 2002, The Duke Endowment made a ten-year

commitment to reduce community levels of child

maltreatment in Durham County, NC

• Duke University Center for Child and Family Policy

created Family Connects in 2008

The Challenge

The Family Connects Model

Nurse connects with family

Nurse connects family to

community resources

Parent connects with infant

Family Connects National Dissemination Sites

TRENDS IN PHILANTHROPY

• Focus on data, evidence and impact

• Collaboration with other funders

• Working with government

• Longer-term commitment

• Place-based investments

SITE FOR PLANNED PLACE-BASED INVESTMENT

*

Union

Lee

Anderson

Berkeley

Charleston

Darlington

Dorchester

Florence

Greenville

Horry

Kershaw

Lexington

Newberry

Oconee

Richland

Spartanburg

York

Beaufort

Abbeville

Allendale

BambergBarnwell

Chesterfield

Clarendon

Dillon

Edgefield

Fairfield

Greenwood

Hampton

Lancaster

Laurens

Marion

McCormick

Orangeburg

Williamsburg

Aiken

Calhoun

Chester

Colleton

Georgetown

Jasper

Pickens

Saluda Sumter

Cherokee

CurrituckAlleghany

Anson

Bertie

Bladen

Burke

Caldwell

Camden

Caswell

Clay

Cleveland

Columbus

Cumberland

Duplin

Gates

Graham

Greene

Halifax Hertford

Hyde

Jones

Lenoir

Martin

McDowell

Mitchell

Montgomery

Northampton

Richmond

Robeson

Rockingham

Rutherford

Scotland

Surry

Tyrrell

Vance

Warren

Washington

Wayne

Wilson

Yancey

AlamanceAlexander

Ashe

Avery

Catawba

Chowan

Craven

DareDavidson

Davie

Gaston

Granville

Harnett

Hoke

Jackson

Macon

Madison

Nash

Onslow

Pamlico

Pasquotank

Pender

Perquimans

Person

Pitt

Polk

RandolphRowan

Sampson

Stanly

Stokes

Swain

Transylvania

Watauga WilkesYadkin

Beaufort

Cherokee

Lee

Brunswick

Buncombe

Cabarrus

Carteret

Chatham

Durham

ForsythFranklin

Guilford

Haywood

Henderson

Iredell

JohnstonLincoln

Mecklenburg Moore

New Hanover

Orange

Union

Wake

Edgecombe

Marlboro

Outcome Area Measures (source)

Planned and Well-Timed

Pregnancies

1. Pregnancies are planned (prenatal interview, CCNC)

2. Subsequent births occur no sooner than 24 months (birth records, NC DHHS)

3. Fewer teen births (birth records, NC DHHS)

Healthy Births1. Children are born at a healthy weight (birth records, NC DHHS)

2. Children are born after 36 weeks gestation (birth records, NC DHHS)

On-Track Development at

18 and 36 Months

1. Children demonstrate age-appropriate emotional and social development

(original data collection, 18 and 36 months)

2. Children demonstrate age-appropriate emerging literacy skills (original data

collection, 18 and 36 months)

3. Children demonstrate physical well-being and appropriate motor development

(original data collection, 18 and 36 months)

School Readiness at

Kindergarten

1. Children demonstrate competence in all five domains of school readiness

(Kindergarten Entry Assessment, NC DPI)

Success in Third Grade

1. Children read proficiently in grade 3 (End of Grade test [proficiency rates and

means], NC DPI)

2. Children perform math proficiently in grade 3 (End of Grade test [proficiency

rates and means], NC DPI)

3. Children have age-appropriate social-emotional skills by end of third grade (K-3

Formative Assessment, NC DPI)

Outcome Area Measures (source)

Planned and Well-Timed

Pregnancies

1. Pregnancies are planned (prenatal interview, CCNC)

2. Subsequent births occur no sooner than 24 months (birth records, NC DHHS)

3. Fewer teen births (birth records, NC DHHS)

Healthy Births1. Children are born at a healthy weight (birth records, NC DHHS)

2. Children are born after 36 weeks gestation (birth records, NC DHHS)

On-Track Development at

18 and 36 Months

1. Children demonstrate age-appropriate emotional and social development

(original data collection, 18 and 36 months)

2. Children demonstrate age-appropriate emerging literacy skills (original data

collection, 18 and 36 months)

3. Children demonstrate physical well-being and appropriate motor development

(original data collection, 18 and 36 months)

School Readiness at

Kindergarten

1. Children demonstrate competence in all five domains of school readiness

(Kindergarten Entry Assessment, NC DPI)

Success in Third Grade

1. Children read proficiently in grade 3 (End of Grade test [proficiency rates and

means], NC DPI)

2. Children perform math proficiently in grade 3 (End of Grade test [proficiency

rates and means], NC DPI)

3. Children have age-appropriate social-emotional skills by end of third grade (K-3

Formative Assessment, NC DPI) 39

VALUE-ADDS

40

Programs Programs Systems Systems

Systems Systems Systems Systems

READY FOR SCHOOL, READY FOR LIFE

INTEGRATION OF

EVIDENCE-BASED

PROGRAMS

42

Family Connects

Nurse Family Partnership

Healthy Steps

CCNC: Pregnancy

Home Model

Linked information system to share data & assessments

CAPACITY BUILDING FOR INCUMBENT PROVIDERS

44

Family Connects

Nurse Family Partnership

Healthy Steps

CCNC: Pregnancy

Home Model

Up to 30 servicesRoot Cause

(Boston)

FAMILY NAVIGATION SYSTEM

46

Family Connects

Nurse Family Partnership

Healthy Steps

CCNC: Pregnancy

Home Model

COMMUNITY-WIDE DATA INFRASTRUCTURE

48

Family Connects

Nurse Family Partnership

Healthy Steps

CCNC: Pregnancy

Home Model

VALUE-ADDS

49

Programs Programs Systems Systems

Systems Systems Systems Systems

TRENDS IN PHILANTHROPY

• Focus on data, evidence and impact

• Collaboration with other funders

• Working with government

• Longer-term commitment

• Place-based investments

STRENGTHENING LIVES AND COMMUNITIES BY…