Nobel Laureate economist James Heckman made a striking discovery when he examined the results of many kinds of health programs. He found that interventions to support children in their early years showed the most positive long-term health outcomes and were the best financial investments. In fact, the most successful program—a preschool for disadvantaged kids—showed that for every $1 spent, the program saved $17 in future costs to society. The three-year-olds who attended the school were twice as likely to graduate high school and college, have stable jobs, and be healthy than children without this opportunity.
Because “parents are their children’s best teachers,” it is especially important to support parents of young children. However, research shows that many parents in California and nationwide have said that it is hard to know how to give their children the best start in life. In 2000, under the leadership of movie director and children’s advocate Rob Reiner, California enacted a tobacco tax to fund programs for children 0-5 years old and their parents. One of the most innovative activities of this First 5 California initiative has been the development of the Kit for New Parents. These “operating instructions” help parents of young children learn about pregnancy, child safety, early learning, and healthy eating, and exercise.
The School of Public Health’s Health Research for Action (HRA) center helped First 5 develop and test the kit. We developed the UC Berkeley Parents Guide with input from culturally diverse parents, experts, and health care providers, and we advised on the development of other resources. The resulting kit—available in five languages—is a colorful briefcase that includes easy-to-use DVDs, printed resources, and a book to read to babies. The kits are now distributed for free to about 500,000 new parent families each year in California through county prenatal programs, maternity hospitals, childcare, preschools, and many other organizations.
At HRA, we led a three-year research study to evaluate the effectiveness of the kits and found remarkable results. Over 88 percent of parents reported using their kits within six weeks after receiving it. Parents who got a kit showed greater learning and adopted healthier practices—like reading to babies, taking steps to childproof their homes, and using better child feeding practices—than parents who did not get a kit. Parents commented that they liked having a home resource that they could use over time and share with other family members and friends. Another important finding was that low-income and immigrant parents were especially likely to appreciate and benefit from the kit.
The kit model has now been extended to four other states: Alabama, Arizona, Kentucky, and Pennsylvania. In each of these states, HRA has worked with stakeholders, such as legislators, health departments, foundations, communities, and private industry, to customize a new kit initiative. In particular, we have supported our colleagues in other states to adopt user-centered design strategies in which diverse parents and stakeholders help create the new kit. The UC Berkeley Parents Guide has been a key feature of each of these kits. Each state partner has adapted the kit model and developed innovative distribution strategies.
In this economic environment, choosing successful health programs is critical. The positive outcomes and modest cost of the kits (about $17 per family in California) shows they are a wise investment in our children’s future.
Linda Neuhauser DrPH ‘88, MPH ‘77 is co-principal investigator of Health Research for Action.