Share This Publication

Issue Brief 54 - Enhancing Early Childhood Systems of Care in High-Need Communities

May 31, 2017

issue brief banner.pngEnhancing Early Childhood Systems of Care in High-Need Communities: Strategies from New Britain Promising Starts Initiative


When young children show signs of physical, emotional, or behavioral problems, interventions at the earliest possible point can prevent or reduce later developmental challenges. The best outcomes can be achieved with comprehensive approaches that include health promotion, prevention, early identification, and early intervention strategies and supports. These approaches are especially needed in underserved communities where rates of developmental problems tend to be the highest.

In Connecticut, Wheeler Clinic applied for and was awarded a federal Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health) grant from 2010-2015, locally referred to as New Britain Promising Starts. The grant helped the New Britain community develop an early childhood system of care that promoted wellness and school readiness, prevented and reduced developmental risk factors, and provided early interventions through improved systems infrastructure and expanded services for children from birth to age 8. CHDI served as the lead evaluator for the grant initiative, working in collaboration with Lorentson Consulting.

Strengthening Early Childhood Systems of Care in New Britain

A 2010 needs assessment found that young children in New Britain demonstrated significant rates of developmental challenges, including:

  • 31.6% of children living below the poverty level
  • 3 of every 4 children in 3rd grade reading below grade level
  • 58% of children entering kindergarten as overweight or obese

To address these needs, the New Britain Promising Starts initiative conducted an environmental scan to determine the availability and gaps in early childhood services. The scan informed a collaborative five-year strategic plan to enhance and coordinate early childhood systems. This guided Promising Starts activities allowing them to provide nearly 1,000 children and their families with prevention, assessment, and intervention services and supports.

chart_Page_2.jpg CHDI’s final evaluation of Promising Starts indicated significantly improved collaboration, coordination, and implementation supports across early childhood serving systems (i.e., early care and education, home visiting, primary care, mental health, and child welfare), resulting in enhanced services to support young child wellness. New Britain has sustained this programming beyond the grant period with ongoing workforce development, system infrastructure enhancements, and lasting collaborative partnerships. As part of the initiative, the Coalition for New Britain Youth also established an annual community report card to monitor key child health and wellness indicators.  

The process used by New Britain Promising Starts and other Project LAUNCH grantees nationwide offers high-need communities a model for enhancing their own early childhood systems and services through a public health approach that addresses five core strategies (see Table 1).

Table 1:  Crosswalk of Public Health Framework, LAUNCH Five Community-Based Strategies and New Britain/Wheeler LAUNCH Activities

crosswalk doc_phframe_LAUNCH crop_Page_1 copy.jpg

Strategies from Promising Starts Can Benefit Other High-Need Communities 

The lessons learned during this successful five-year initiative have helped to inform state policy by contributing to early childhood recommendations in the statewide Children’s Behavioral Health Plan and the Early Childhood Home Visiting Consortium. The successes of New Britain Promising Starts have also supported a statewide scale-up of early childhood prevention, screening, and early intervention services and provided effective strategies for the development and sustainability of early childhood systems in alignment with the work of the Office of Early Childhood. With continued state support, these services and strategies can help communities across the State support the health and development of young children.

For more information on Promising Starts—Wheeler Clinic’s New Britain Project LAUNCH, contact Jeana Bracey ( or Melissa Mendez ( Related publications include the Project LAUNCH e-book: Implementation of Young Child Wellness Strategies in a Unique Cohort of Local Communities and the final local evaluation report.