Helping Community Health Centers Enhance Early Childhood Developmental Services: Highlights From a Needs Assessment Survey

ECDHS: Evidence to Impact Center
Center Insights
December 3, 2024
Explore highlights from a needs assessment survey of 151 community health centers to identify technical assistance opportunities to improve early childhood developmental services.
woman holding a baby with a woman in the background holding a carseat

In November 2023, the ECDHS: Evidence to Impact Center disseminated a needs assessment survey with 151 community health centers funded by the Health Resources and Services Administration to enhance early childhood developmental (ECD) screenings, follow-up services, and integrated ECD care team expertise. In support of this ECD grant, we provide technical assistance to help the health centers improve developmental outcomes for their patients ages 0-5. 

Our survey was designed to gather a snapshot of the health centers, including their current ECD resources and top technical assistance priorities. Of the 151 community health center grantees, 121 centers completed the survey for an exciting 81% response rate. Respondents represented 40 states and territories from across the U.S.

We use the findings from this survey to inform our technical assistance offerings for the health centers so they can better serve young children and families. Below are highlights of what we heard from respondents.  

In the survey, community health centers were invited to rank key technical assistance topic areas from “most support needed” to “least support needed.” The highest prioritized topics across all respondents, as identified by statistical analyses, were related to information technology (IT), access and affordability, and workforce. These results have shaped the ECDHS: Evidence to Impact Center’s plans for technical assistance offerings, such as potential webinars, learning collaboratives, and engagements with subject matter experts.

Top Three Technical Assistance Topics

  1. Information Technology (IT): Leverage IT platforms to facilitate and collect data around community resource referral and care coordination.
  2. Access and Affordability: Establish or strengthen partnership with Medicaid.
  3. Workforce: Early childhood workforce training, including for existing health center staff to expand or enhance their ECD expertise.

Implementing the ECD Care Continuum in Community Health Centers

Community health centers were asked about their experiences implementing the ECD Care Continuum. Participants were given a common definition of the continuum, which includes developmental health promotion and prevention, screening and surveillance, linkage and care coordination for appropriate follow-up, and consultation or brief intervention. (Learn more about implementing the ECD Care Continuum by watching this webinar recording.)

continuum graphic with four categories: promotion and prevention, monitoring and screening, care coordination and linkage, and intervention
ECD Care Continuum

Developmental Screening Phases

Respondents were asked, “In which phase of developmental screening implementation for children birth to five years old is your health center?” As of November/December 2023, nearly one-third (30.3%) of respondents have been conducting developmental screenings for children birth to five for less than one year at their health centers.

bar chart showing the percentage of community health centers that have implemented developmental screening
Percentage of surveyed community health centers (n=122) who responded to the question, “In which phase of developmental screening implementation for children birth to five years old is your health center?”

Please note that this survey question focused on the overall process and did not reflect screening rates. According to the 2022-2023 National Survey of Children’s Health, current developmental screening rates for children 9-35 months of age is 35.6% and lower for those with public insurance.


Providing Services According to the ECD Care Continuum

Respondents were asked, “To what extent is your health center providing early childhood developmental services according to the ECD Care Continuum?” Respondents were instructed to select all options that apply. As of November/December 2023, the majority of health centers are implementing at least one stage of the continuum to some extent.

table showing the total number and percentage of community health centers that providing early childhood developmental services according to a continuum of care
Total response count and percentage of surveyed community health centers (n=122) who responded to the question, “To what extent is your health center providing early childhood developmental services according to the ECD Care Continuum?”

Of the 122 community health center respondents, 63.9% provided they are implementing at least one of the following ECD models: CenteringParenting, CenteringPregnancy, DULCE, HealthySteps, Medical Legal Partnership, and Reach Out and Read.

63.9%

63.9% of health centers implement at least one surveyed ECD model.

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