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FIRST 5 SANTA CRUZ COUNTY

July 1, 2014 - June 30, 2015

October 2015

ANNUAL EVALUATION REPORT

Acknowledgements

First 5 Santa Cruz County would like to acknowledge Applied Survey Research for their evaluation

support and assistance. 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.

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

David G. Brody Stephanie Bluford Vicki Boriack Barbara Dana Alicia Fernandez Irene Freiberg Holly Maclure Christine Sieburg Karen Sullivan Xochitl Ybarra Alicia Zenteno

Lisa Colvig-Niclai Kim Carpenter Javier Salcedo Emmeline Taylor

Nicole M. Young

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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 .................................................................... 14

Summary ............................................................................................................................... 15

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

First 5 Santa Cruz County’s Strategic Framework .................................................................... 18

Overall Well-Being of Children in the County .................................................................... 19

A Profile of Santa Cruz County’s Youngest Children ................................................................ 19

County-Wide Trends in Indicators of Child and Family Well-Being .......................................... 20

Profile of Participants ......................................................................................................... 21

Number of Children and Families Served ................................................................................ 21

Increase Services into Communities with the Highest Needs .................................................. 23

Early Childhood Educators Served by First 5 Partners ............................................................. 26

Healthy Children ................................................................................................................ 27

Increase Insurance Coverage .................................................................................................. 27

Increase Use of Medical/Dental Homes .................................................................................. 31

Increase Use of Preventive Health Services ............................................................................ 33

Increase Number of Children Reaching Developmental Milestones ........................................ 34

Strong Families .................................................................................................................. 37

Decrease Child Abuse and Neglect ......................................................................................... 37

Improve Parent and Caregiver Practices that Support Children’s Social and Emotional Development ......................................................................................................................... 39

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

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

Improve Early Literacy Skills of Children ................................................................................. 52

Service Integration & Community Strengthening ................................................................ 69

First 5 Service Integration ....................................................................................................... 69

First 5 Fiscal Status and Sustainability .................................................................................... 70

Community Strengthening ..................................................................................................... 72

TABLE OF CONTENTS FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT

ii FIRST 5 SANTA CRUZ COUNTY

Part 2: Partner Profiles ................................................................ 75

Healthy Children ................................................................................................................. 77

Healthy Kids Initiative ............................................................................................................ 77

Stanford Neurodevelopmental Foster Care Clinic ................................................................... 81

Strong Families ................................................................................................................... 86

Families Together .................................................................................................................. 86

Triple P – Positive Parenting Program .................................................................................... 97

Triple P Highlights ................................................................................................................................... 99

Population Served ................................................................................................................................. 111

Details of Program Participation .......................................................................................................... 114

Building a Population-Based System of Parent Education ................................................................... 121

La Manzana Community Resources ...................................................................................... 124

Mountain Community Resources ......................................................................................... 131

Side-by-Side ......................................................................................................................... 138

Children Learning and Ready for School .......................................................................... 141

Quality Early Learning Initiative ........................................................................................... 141

Race to the Top – Early Learning Challenge ......................................................................................... 141

Child Signature Program (CSP) ............................................................................................................. 143

Starlight Children’s Center ................................................................................................... 147

Early Literacy Foundations (ELF) Initiative ............................................................................ 151

SEEDS of Early Literacy ......................................................................................................................... 152

Santa Cruz Reading Corps..................................................................................................................... 154

Raising A Reader .................................................................................................................. 170

Summer Pre-K Academy ...................................................................................................... 173

Transition to Kindergarten ................................................................................................... 175

Transition to Kindergarten Workshops ................................................................................................ 175

Appendices ................................................................................ 177

Appendix A: First 5 Santa Cruz County Strategic Framework ................................................ 179

Appendix B: Race to the Top–Hybrid Quality Continuum Framework and Tiers Matrix ......... 181

Appendix C: Measurement Tools ......................................................................................... 183

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT TABLE OF FIGURES

FIRST 5 SANTA CRUZ COUNTY iii

Table of Figures

Figure 1: Number of County Children ages 0-5 .................................................................................................................. 19

Figure 2: Ethnicity of County Children ages 0-5 (2015) ..................................................................................................... 19

Figure 3: English Language Proficiency of County Kindergarteners (2014-15) .................................................................. 19

Figure 4: Number of Services to Children and Parents, by Goal Area (2014-2015) ........................................................... 21

Figure 5: Percentage of Children 0-5 in Santa Cruz County Served by First 5 .................................................................... 22

Figure 6: Demographics of Children Participating in First 5 Programs, by Year ................................................................. 23

Figure 7: Levels of Children’s Vulnerability in Santa Cruz County, by ZIP code .................................................................. 24

Figure 8: Distribution of County Children Who Received Services, by ZIP Code (2014-2015) ............................................... 25

Figure 9: Number of County Children Who Received Services, by ZIP Code (2014-2015) ................................................ 25

Figure 10: Percentage of Children Ages 0-5 Estimated to be Insured .................................................................................. 27

Figure 11: Number of Children (Ages 0-5) Newly Enrolled in Publicly-Funded Health Insurance Programs (with Assistance from First 5-funded CAAs) ................................................................................................................. 29

Figure 12: Newborn Enrollment Project Statistics (2014-2015) ........................................................................................... 30

Figure 13: Percentage of County Children Enrolled in Healthy Kids (Ages 2-6) Who Had Access to a Primary Care Practitioner .................................................................................................................................... 31

Figure 14: Percentage of Children (Ages 0-5) Who Utilized Health Care Prior to Renewal in an Insurance Program (renewed through First 5-funded CAAs) ............................................................................................................. 31

Figure 15: Percentage of County Children Receiving Dental Care ....................................................................................... 32

Figure 16: Rate of California Children Visiting the ED for Preventable Dental Conditions (per 100,000, Ages 0-5) ............ 32

Figure 17: Percentage of County Children (Ages 3-6) the County Enrolled in Healthy Kids Who Received a Well-Child Visit .................................................................................................................................................... 33

Figure 18: Number of Emergency Department Visits (Infants Less Than One Year Old) ..................................................... 34

Figure 19: Percentage of County Children in Kindergarten Enrolled in Special Education .................................................. 34

Figure 20: Demographics of the Children (Ages 0-5) Participating in the SNDFCC (2011-2015) .......................................... 35

Figure 21: Percentage of Children in SNDFCC (Ages 0-5) With These Diagnoses and Services, at Intake (2011-2015) ....... 36

Figure 22: Percentage of Children in SNDFCC (Ages 0-5) Provided With These Referrals (2011-2015) ............................... 36

Figure 23: Rate of Substantiated Allegations of Child Maltreatment in Santa Cruz County and California (per 1,000)....... 37

Figure 24: Change in Families’ Risk Levels During Participation in the Families Together Program (July 2007 – June 2015) ....................................................................................................................................... 38

Figure 25: Impact of Triple P on Parents with More Serious Parenting Issues..................................................................... 41

Figure 26: Parents’ Use of Positive Parenting Styles (2010-2015) ....................................................................................... 44

Figure 27: Number of Child Behaviors Perceived to Be a Problem (2010-2015) .................................................................. 46

Figure 28: Ratings of QRIS Sites in Santa Cruz County ......................................................................................................... 49

Figure 29: Percentage of 3rd Grade Students Performing at the Proficient/Advanced Levels In English/Language Arts ..... 52

Figure 30: Achievement Levels of 3rd Grade Students In English Language Arts/Literacy (2015) ........................................ 53

Figure 31: Percentage of 3rd Grade Students—Who are English Learners—Performing at the Early Advanced/Advanced Levels In English Language Development ................................................................. 54

Figure 32: Number of Early Childhood Educators Who Have Completed SEEDS Trainings ........................................................ 58

Figure 33: Number of SEEDS-Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007-2015) ......................................................................................................................................................... 59

Figure 34: Key Demographics of SEEDS-Trained Early Childhood Educators in Licensed Programs (2007-2015) ................ 59

Figure 35: Number of Children Participating in Raising A Reader (2014-2015) ................................................................... 60

Figure 36: Reading Corps Classrooms: Children Ages 4+ Who Are At/Above Targets for Later Reading Success, in English (2012-2015) ............................................................................................................................................ 63

Figure 37: Children in Reading Corps Classrooms: Average Scores and Average Growth in Scores (Fall to Spring) – in English .......................................................................................................................................................... 64

TABLE OF FIGURES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT

iv FIRST 5 SANTA CRUZ COUNTY

Figure 38: Impact of Tailored Interventions on Children’s Proficiency in Key Pre-Literacy Skills (2014-2015) – in English .......................................................................................................................................................... 66

Figure 39: Impact of Tailored Interventions: Average Scores and Average Growth in Scores (Fall to Spring) ..................... 67

Figure 40: Changes in Students’ Letter Sound Recognition Skills After Participation in the Migrant Education Summer Pre-K Academy (2015) .......................................................................................................................... 68

Figure 41: Percentage of Children Receiving Services from Multiple First 5 Partners ......................................................... 69

Figure 42: Statement of Activities, Fiscal Year 2014-2015 ................................................................................................... 70

Figure 43: Amount of Funding Leveraged by Partners, by Type (2014-2015) ...................................................................... 71

Figure 44: Total Amount of First 5 Funding and Leveraged Investments (2014-2015) ........................................................ 71

Figure 45: Number of 2-1-1 Callers, Needs, and Service Referrals ...................................................................................... 72

Figure 46: Types of 2-1-1 Callers’ Needs (2011-2015) ......................................................................................................... 73

Figure 47: Types of 2-1-1 Service Referrals (2011-2015) ..................................................................................................... 73

Figure 48: Newborn Enrollment Project Statistics (2014-2015) ........................................................................................... 79

Figure 49: Number of Emergency Department Visits (Infants Less Than One Year Old) ..................................................... 80

Figure 50: Demographics of the Children (Ages 0-5) Participating in the SNDFCC (2011-2015) ................................................. 84

Figure 51: Percentage of Children in SNDFCC (Ages 0-5) With These Diagnoses and Services, at Intake (2011-2015) ....... 84

Figure 52: Percentage of Children in SNDFCC (Ages 0-5) Provided With These Referrals (2011-2015) ............................... 85

Figure 53: Case Flow Diagram (2014-2015) ......................................................................................................................... 88

Figure 54: Percentage of Families Together Participants Who Showed Decreased Risk of Child Maltreatment ................. 89

Figure 55: Change in Families’ Risk Levels During Participation in the Families Together Program (July 2007 – June 2015) ....................................................................................................................................... 90

Figure 56: Percentage of Families Together Participants Who Do Not Have a Substantiated Allegation of Maltreatment Within 6 Months After Case Closure ........................................................................................... 91

Figure 57: Child Welfare Issues Occurring After Exit from Families Together (2014) .......................................................... 91

Figure 58: Increases in Positive Parenting (Families Together: 2010-2015)......................................................................... 92

Figure 59: Parents’ Use of Positive Parenting Styles (Families Together: 2010-2015) ......................................................... 93

Figure 60: Number of Parenting Issues That Have Been a Source of Conflict Between Parents (Families Together: 2010-2015) .......................................................................................................................................................... 94

Figure 61: Level of Parental Depression, Anxiety, and Stress (Families Together: 2010-2015) ........................................... 95

Figure 62: Number of Child Behaviors Perceived to Be a Problem (Families Together: 2010-2015) ................................... 96

Figure 63: Parents’ Satisfaction with Various Aspects of the Triple P Program (Families Together: 2010-2015) ................ 96

Figure 64: Demographics of Triple P Parents/Guardians (2010-2015) ............................................................................... 112

Figure 65: Ages of Children Chosen as the “Index” Child (2010-2015) .............................................................................. 113

Figure 66: Types of Services Provided (2010-2015) ........................................................................................................... 113

Figure 67: How Participants First Heard about Triple P (2010-2015) ................................................................................. 114

Figure 68: Percentage of Participants Who First Heard about Triple P from Media and Advertisements ......................... 114

Figure 69: Percentage of Parents Who Completed Their Multi-Session Triple P Services (2010-2015) ............................. 115

Figure 70: Percentage of Parents Whose Satisfaction with Their Partner Improved, With and Without Participation with Another Adult (2010-2015) ....................................................................................................................... 116

Figure 71: Parents’ Satisfaction with the Triple P Program (2010-2015) ........................................................................... 117

Figure 72: Number and Types of Organizations with Accredited Triple P Practitioners, by Triple P Level (2014-2015) .... 121

Figure 73: Number of Accredited Triple P Practitioners .................................................................................................... 122

Figure 74: Types of Triple P Services Provided (LMCR: 2014-15) ....................................................................................... 125

Figure 75: Increases in Positive Parenting (LMCR: 2010-2015) .......................................................................................... 125

Figure 76: Parents’ Use of Positive Parenting Styles (LMCR: 2010-2015) .......................................................................... 126

Figure 77: Number of Parenting Issues That Have Been a Source of Conflict Between Parents (LMCR: 2010-2015) ........ 127

Figure 78: Level of Parental Depression, Anxiety, and Stress (LMCR: 2010-2015)............................................................. 127

Figure 79: Number of Child Behaviors Perceived to Be a Problem (LMCR: 2010-2015) .................................................... 129

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT TABLE OF FIGURES

FIRST 5 SANTA CRUZ COUNTY v

Figure 80: Parents’ Satisfaction with Various Aspects of the Triple P Program (LMCR: 2010-2015) ................................. 130

Figure 81: Types of Triple P Services Provided (MCR: 2014-15) ......................................................................................... 132

Figure 82: Parents’ Use of Positive Parenting Styles (MCR: 2010-2015) ............................................................................ 133

Figure 83: Number of Parenting Issues That Have Been a Source of Conflict Between Parents (MCR: 2010-2015) ......... 133

Figure 84: Level of Parental Depression, Anxiety, and Stress (MCR: 2010-2015) .............................................................. 134

Figure 85: Number of Child Behaviors Perceived to Be a Problem (MCR: 2010-2015) ...................................................... 136

Figure 86: Parents’ Satisfaction with Various Aspects of the Triple P Program (MCR: 2010-2015) ................................... 137

Figure 87: Distribution of RTT-ELC Sites in the County (2014-15) ...................................................................................... 142

Figure 88: Ratings of QRIS Sites in Santa Cruz County ....................................................................................................... 144

Figure 89: Changes in Levels in Key Developmental Areas (2014-15) ................................................................................ 149

Figure 90: Number of SEEDS-Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007-2015) ....................................................................................................................................................... 156

Figure 91: Key Demographics of SEEDS-Trained Early Childhood Educators in Licensed Programs (2007-2015) .............. 157

Figure 92: Preschool and Transitional Kindergarten Classrooms: Support for Language and Literacy (2014-2015) ......... 158

Figure 93: Preschool and Transitional Kindergarten Classrooms: Key Language and Literacy Supports (2007-2015) ....... 159

Figure 94: Family Child Care Settings: Support for Language and Literacy (2007-2015) ................................................... 161

Figure 95: Reading Corps Classrooms: Children Ages 4+ Who Are At/Above Targets for Later Reading Success, in English (2012-2015) ....................................................................................................................................... 163

Figure 96: Children in Reading Corps Classrooms: Average Scores and Average Growth in Scores (Fall to Spring) – in English ........................................................................................................................................................ 164

Figure 97: Impact of Tailored Interventions on Children’s Proficiency in Key Pre-Literacy Skills (2014-2015) – in English ........................................................................................................................................................ 166

Figure 98: Impact of Tailored Interventions: Average Scores and Average Growth in Scores (Fall to Spring) ................... 168

Figure 99: Percentage of RAR Providers Who Noted These Key Pre-Literacy Findings (2014-15) ..................................... 171

Figure 100: Percentage of RAR Parents Who Practiced These Key Pre-Literacy Activities with Their Child (2014-15) ........ 172

Figure 101: Summer Pre-K Academy Letter Sound Recognition Results (2015) .................................................................. 174

Figure 102: Percentage of Summer Pre-K Academy Students who Increased Their Letter Sound Recognition By At Least 5 Letter Sounds ................................................................................................................................... 174

Figure 103: Average Increase in the Number of Letter Sounds Recognized by Summer Pre-K Academy Students ............. 174

TABLE OF FIGURES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT

vi FIRST 5 SANTA CRUZ COUNTY

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT EXECUTIVE SUMMARY

FIRST 5 SANTA CRUZ COUNTY 1

EXECUTIVE SUMMARY

EXECUTIVE SUMMARY FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT

2 FIRST 5 SANTA CRUZ COUNTY



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, 2014 to June 30, 2015. 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 2014-2015 marks the third 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 2015, there

were 18,824 children ages 0-5 in Santa Cruz County, the majority of whom were either

Hispanic (56%), or White (37%). This diversity continues into kindergarten, where in 2015

almost 43% of children had a primary language other than English.

1 http://developingchild.harvard.edu

First 5 Santa Cruz County’s Vision

All Santa Cruz County

children enter school

ready to achieve to

their greatest potential.

First 5 Santa Cruz County’s MissionTo 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.



Unemployment Is falling, but varies greatly across the County. The County’s falling

unemployment rate reflects the slow recovery from the economic recession. With a current

unemployment rate in the County of 8%, it is lower than it was in 2011 (13%).2 Within the

County, the percent of unemployed residents differs greatly by

area; the average unemployment rate ranges from 4% in Felton

to 10% in Watsonville.

Salaries are rising, but many are still living in poverty. Although

the median family income has been rising, it is still not enough

for many in this County to make ends meet. Almost 17% of all

people in the County are earning less that the Federal Poverty

Level, and 18% of all children ages 0-5 are living in poverty.

When incomes are measured using the Self-Sufficiency Standard,

which is a more comprehensive measure of income adequacy

than the Federal Poverty Level, 60% of families in Santa Cruz

County are not able to meet their basic needs.

There is varying enrollment in public assistance programs. Over

the last five years there has been a 41% increase in the number

of residents participating in CalFresh (Food Stamps), and the number of County students

receiving Free and Reduced Price Meals has increased 12%. Interestingly, over the last five

years the enrollment in the Women, Infants, & Children Program slightly decreased (-8%),

and the number of County residents participating in CalWORKS decreased 20%.

Not enough young mothers are receiving prenatal care in the first trimester. In 2014, the

percentage of mothers who received prenatal care in their first trimester was high – 80% —

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 68% 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. In 2014, only 72% of mothers with

Medi-Cal began receiving prenatal care during the first trimester, compared to 90% of

mothers with private insurance.

The percentage of births to teen mothers in the County is slowly decreasing. In 2014, the

percentage of births to teen mothers represented 6% of all births in Santa Cruz County, and there

was a teen birth rate of 18 per 1,000 (ages 15-19). In the last five years 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 2014, 53% of

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

83% of the births to women under the age of 25.

2 In January 2015 the U.S. Bureau of Labor Statistics substantially changed the methodology used to calculate unemployment rates and

introduced population adjustments based upon the 2010 Census, which resulted in significant changes to unemployment rates. Only the years that were updated (2010-2015) are included in this report.

- National Center for Children in Poverty, 2014 < http://www.nccp.org>

“Poverty can impede children’s

ability to learn and contribute to

social, emotional, and behavioral

problems. Poverty also can

contribute to poor health and

mental health.

Risks are greatest for children who

experience poverty when they are

young and/or experience deep and

persistent poverty.

Research is clear that poverty is the

single greatest threat to children’s

well-being.”



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 2014-15, First 5 partners served 6,328 children

ages 0-5 (unduplicated), representing 34% 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, 77%

were Latino, and 58% of children spoke Spanish in their household. Of all Latino children ages

0-5 in Santa Cruz County, 46% 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 (88%) 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 2014-2015 include:

Skill development and coaching for early childhood educators. In 2014-15, 69 early

childhood educators from preschools and family child care homes received professional

development training from the SEEDS of Early Literacy program, 92 providers attended a

Race to the Top (RTT) Workshop and received a stipend, and 23 Family Child Care providers

received a stipend to participate in Race to the Top - Early Learning Challenge (RTT ELC). In

addition, staff in 57 state and federally funded classrooms and 23 Family Child Care homes

who participated in the Race to the Top – Early Learning Challenge quality improvement

efforts received professional development training; hundreds of early childhood educators

who provided the Raising A Reader program to children received training in promoting pre-

literacy skills; and 49 staff/child care providers received early childhood and mental health

training from Side-by-Side Clinician/Consultants.



Development of a population-based system of parent education. In 2015, 24 new parent

education practitioners received training to deliver the Triple P – Positive Parenting Program,

an evidence-based curriculum shown to improve parental efficacy, parent-child interaction,

and child behaviors. A total of 165 Triple P practitioners have now been trained in Santa Cruz

County to provide these services.

Distribution of information to community service providers. Thirteen health, social services,

and early education providers received information through First 5’s “Achieving Excellence in

Customer Service” trainings, and 763 Kits for New Parents were shipped to clinics, hospitals,

service providers, and events throughout the County, for distribution to individuals.

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. Because Medi-Cal and Covered California cannot cover all

of the uninsured, First 5 also funds the premiums for children who qualify for the local Healthy

Kids health insurance plan.

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

Kids Initiative in 2004, Certified Application Assistors (CAAs) have assisted with the

applications to enroll 16,111 children ages 0-5 in public health insurance.

The enrollment numbers in public health insurance plans have shown

dramatic changes as families take advantage of some new

opportunities and accommodate the changing eligibility requirements

of various plans.

Children are using their health insurance. During the 2014-2015

year, nearly all children (95%) who received renewal assistance

through First 5-funded CAAs in a public insurance program had

utilized their benefits prior to their renewal, continuing the trend

of high utilization across the years.

Santa Cruz County’s newborns are getting connected to medical care. During 2014-15, Baby

Gateway—the Newborn Enrollment Project—provided 87% of all mothers with a newborn

Since 2004, the Healthy Kids

Initiative has helped 16,111

children ages 0-5 apply for

public health insurance.

In 2014-15, Baby Gateway

assisted 70% of all mothers who

had Medi-Cal births to complete

a Medi-Cal application for their

new babies.



visit while in the hospital. Baby Gateway also assisted 70% of all mothers who had Medi-Cal

births to complete a Medi-Cal application for their new babies, and 80% of these mothers

identified a preferred primary care provider (PCP) or clinic for their child before discharge

from the hospital.

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

Children have a medical home. Most children (84%) ages 2-6 who were enrolled in Healthy

Kids had access to a primary care practitioner, according to the 2014 HEDIS measures.3 The

majority of children (ages 3-6) in Healthy Kids also had a well-

child visit (65%). These are lower percentages than in the

past, and may reflect the changing population of children

enrolled in Healthy Kids in 2014.4

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 The services provided by the Newborn Enrollment Project

may 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 40% at

Watsonville Community Hospital, and 4% at Dominican Hospital.

Children are getting dental care. In 2014, the majority of children ages 2-6 enrolled in

Healthy Kids (73%) had a dental visit within the past year.

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

neurodevelopmental needs are getting referred to supportive services through a coordinated

and multidisciplinary system called the Stanford Neurodevelopmental Foster Care Clinic.

3 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, 2014 results are for the time period January 1 - December 31, 2014.

4 Due to Health Care Reform, by January 1, 2014 all children eligible for subsidized coverage under Covered California were moved from

Healthy Kids to Covered California, leaving undocumented children as the primary client population for Healthy Kids.

Uninsured children are:

Over 13 times more likely to lack a

usual source of care;

Nearly 5 times more likely to have

delayed or unmet medical needs;

Over 3 times more likely to have

unmet mental health service

needs;

5 times more likely to have unmet

dental and vision care needs;

Nearly 4 times more likely to have

an unmet need for prescription

drugs.

- Children Now, 2014 <http://www.childrennow.org>



Strong Families

Santa Cruz County historically has had higher rates of child abuse and neglect than other counties in

the Bay Area.5 Fortunately, the rates of child maltreatment are decreasing, and in 2014 the County

rate of substantiated allegations of child maltreatment was 6.8 per 1,000 , lower than the state-wide

rate (9.0 per 1,000).

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, 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 assessments, 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 some 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.

5 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. The U.S. Office of Management and Budget defines the “Bay Area” as the 12 counties that comprise the San Jose-San Francisco-Oakland, CA Combined Statistical Area (CSA).

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

64% to 13%.



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, ranging from a media campaign to intensive and focused

individual services. Between 2010-2015, approximately 7,331

parents with 13,246 children participated in the program.

o Parents are engaged and seek more opportunities. Over the

past several years, analyses have consistently shown that brief

services are an effective way of getting parents initially engaged

in the program, and gives them an opportunity to participate in

further services. Parents who attend Seminars and Workshops

frequently request follow-up services, and of parents who

participate in multiple services, those who begin with one or two brief consultations for

specific parenting concerns are likely to return later for in-depth consultations and multi-

session programs.

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

completed assessments that measured their levels of parenting skills and knowledge along

several domains 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

Reduced levels of conflict between parents

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 is particularly true for both parents of

adolescents, and parents of children with special needs.

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. In a survey of Triple P participants, the vast majority reported

experiencing significant and lasting benefits of Triple P services. On average, survey

participants had last participated in Triple P services 10 months prior to the interview. Of

these, 95% reported they continue to use strategies learned from Triple P.

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 in

child care settings. Results indicate that children are greatly benefiting from their

Parents are more confident in

their parenting skills, are

helping to improve their

children’s behavior, and are

building positive relationships

with their families.



participation in Side-by-Side family-based 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 pilot 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 has implemented 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.

Provisional ratings and trainings have been conducted. During this past year, the Early Learning

System Specialist (ELSS) coordinated trainings related to CSP and RTT-ELC, provided technical

assistance to program directors, maintained centralized records, coordinated independent

assessments, and conducted the QRIS ratings. First 5 contracted with Go Kids, Inc. to lead the

QELI Consortium’s quality improvement activities for Family Child Care (FCC) homes. The Go

Kids, Inc. FCC manager recruited FCC providers to RTT-ELC, completed provisional baseline

ratings, and coordinated trainings and independent assessments.

Provisional ratings of all participating QRIS sites in Santa Cruz County were conducted in

December 2014. Based on the 5-tier scale (1=lowest tier; 5=highest tier):

o 23 sites received a Tier 2 provisional rating



o 1 site received a Tier 5 provisional rating

These ratings were considered “Provisional” rather than “Full” ratings, since no sites had

yet received both an independent Classroom Assessment Scoring System (CLASS) and

Environmental Rating Scale (ERS) assessment as of December 2014.



The following table presents the number of early childhood educators who participated

in trainings provided in 2014-15.

TRAINING / COACHING ACTIVITY NUMBER OF PARTICIPANTS

Number of early childhood educators in RTT-ELC/CSP sites who attended the Early Childhood Environmental Rating System (ECERS) training

45 center-based early childhood educators

Number of early childhood educators in RTT-ELC/CSP sites who attended a Make and Take workshop on the Early Childhood Environmental Rating System (ECERS)


Number of early childhood educators in RTT-ELC/CSP sites who attended the training and Make and Take workshop related to the Desired Results Developmental Profile – 2015


Number of directors from state and federally funded programs RTT-ELC/CSP sites participating in monthly technical assistance meetings with the Early Learning Systems Specialist

9 directors

Number of Family Child Care sites participating in monthly technical assistance meetings with the Family Child Care Education Manager

23 family child care sites

Number of participating RTT-ELC/CSP sites receiving training in the Ages and Stages Questionnaire (ASQ)


Number of participating RTT-ELC/CSP sites providing ASQ screenings

44 center sites provided ASQ screenings

20 family child care sites provided ASQ screenings

2 center sites also provided ASQ-SE screenings

Number of early childhood educators in RTT-ELC/CSP who received training in the CLASS tool

22 family child care providers

Number of early childhood educators in RTT-ELC/CSP classrooms who received coaching utilizing the CLASS tool

40 early childhood educators in 9 programs

Source: First 5 Santa Cruz County, 2015.

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

Cruz County is part of a regional consortium that brings six neighboring counties together to

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

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

Regional RTT Database, which gathers scoring information and reviews progress in relation

to the Consortium’s local quality improvement targets.

A model infant/toddler quality site served as a “learning community” that promoted early

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

was a program for families of children 0-3 years old, with the key goal of creating a “learning

community” that promoted early literacy and social/emotional skills. Assessment results from the

DRDP-I/T showed that toddlers in the Starlight Children’s Center were 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,6 and data show that Santa Cruz County children are struggling with their reading

skills. For example:

o In 2015, only 33% of 3rd grade students in Santa Cruz County met or exceeded standards in

English language arts/literacy on the new California Assessment of Student Performance and

Progress (CAASPP).

o In the two-year period 2013-15, only 21% of 3rd grade students—who were English

learners—were performing at the Early Advanced/Advanced Levels In English language

development (CELDT7).

First 5 Santa Cruz County is working to improve these long-term trends 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, 639 educators, tutors, and informal child care providers have been trained in the SEEDS

of Early Literacy curriculum. This includes 53 SEEDS Quality Coaches, 209 educators in state- and

federally-subsidized classrooms, 15 educators in public school

Transitional Kindergarten classrooms, 214 educators in licensed family

child care homes and private/non-profit centers, 155 Family, Friend or

Neighbor (FFN) informal child care providers, and 29 Reading Corps

tutors.

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 and transitional kindergarten (TK) classrooms taught by SEEDS-trained early

childhood educators, results from the Early Language and Literacy Classroom Observation

tool show that in 2014-15, the percentage of classrooms that provided high quality

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

7 California English Language Development Test (CELDT).

639 early child educators,

Reading Corps tutors, and

informal family child care

providers throughout the

county have been trained to

promote strong language and

literacy foundations for

children.



support for early literacy increased from 20% at pre-assessment to 93% at

post-assessment.

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

Observation tool indicate that in 2014-15, the percentage of family child care settings that

were rated as having high quality support for early literacy increased from 44% to 89%.

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 2014-15 fiscal year, 4,129 children

and their families participated in the program throughout the county.

Children are developing skills in key areas of reading success. In 2014-15, the Santa Cruz

Reading Corps (SCRC) placed one AmeriCorps volunteer (called a Literacy Tutor) in each State

Preschool classroom in the Pajaro Valley Unified and Live Oak school districts, and also in a

growing number of Transitional Kindergarten classrooms in these

districts. As the majority of preschool students were dual language

learners, there was an emphasis on developing and improving

children’s vocabulary skills in English.

Results show that children who need the biggest boost in key early

literacy areas benefit when they receive “Response to

Intervention” individualized strategies.

o In State Pre-K and TK classrooms:

Children in these SEEDS-trained classrooms improved in all five pre-literacy skill

areas—in English—no matter what their primary language was.

When assessed in English, Spanish-speaking children on average started with lower scores

than English-speaking children, but by their last assessment they had increased their scores

by a higher amount than English-speaking children in Picture Naming and Rhyming, and

nearly equaled the English-speaking children’s increase in scores in Alliteration.

This improvement in English pre-literacy skills was particularly striking among primarily

Spanish-speaking children who had received tailored interventions. An analysis of

average scores on the Fall, Winter, and Spring benchmarks showed that when assessed

in English, Spanish-speaking children who were selected to receive tailored

interventions started with lower scores than Spanish-speaking children who did not

require tailored interventions. But by their last assessment they had increased their

scores by a higher amount in Picture Naming and Rhyming.

This last result is especially encouraging, as it suggests that these children are getting

the tailored help they need to increase their vocabulary and bring them up to a level

- Snow, Burns, & Griffin, 1998

“The seeds of literacy are planted

before children enter school.

Important literacy skills do not

develop spontaneously,

instruction shapes them.”



where they can more fully benefit from the SEEDS of Early Literacy classroom

curriculum with the rest of their peers.

o In the Summer Pre-K Academy:

Children are learning letter sounds. In 2015, 68 children—with little to no prior

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

Academy. Of those who participated in at least 14 sessions, 86% increased their letter

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

recognize 12 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:

Parents are receiving kindergarten transition information. Approximately 314 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 Santa Cruz County seeks to strengthen the system of care for families with children ages

0-5 in the County. In 2014-15, approximately 15% of children received services from multiple

First 5 partners. This occurs partly because First 5 partners cross-refer families, and also

because other agencies refer families into the coordinated network of First 5 services.

Many partners maximize First 5 funding by using their funds to match or leverage additional

funding. In 2014-15, First 5 Santa Cruz County had a total program investment of almost

$4.4 million (via Proposition 10 funding and other funding sources), and an additional

$1.6 million was leveraged by partners.

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 27,212 people have called, with a total of 40,899 needs and 46,101

referrals provided. 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 34% 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, 16,111 children ages 0-5 have been assisted to apply for public health insurance.

o In 2014, 84% of children (ages 2-6) in Healthy Kids had a medical home, and 65% of

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

o In 2014-15, Baby Gateway also assisted 70% of all mothers who had Medi-Cal births to

complete a Medi-Cal application for their new babies, and 80% of these mothers identified a

preferred primary care provider or clinic for their child before discharge from the hospital.

o Foster children with neurodevelopmental needs are getting referred to supportive

services through a coordinated and multidisciplinary system called the Stanford

Neurodevelopmental Foster Care Clinic.

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 94% 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.

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

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

their relationships with their families, and reduced the levels of conflict between parents.

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 of adolescents (Teen Triple P) and parents of children with special needs (Stepping

Stones 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 In a survey of Triple P participants, the vast majority reported experiencing significant and

lasting benefits of Triple P services. On average, survey participants had last participated in

Triple P services 10 months prior to the interview. Of these, 95% reported they continue to

use strategies learned from Triple P.



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 First 5 Cruz County has further developed 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. More sites have been added, provisional ratings and trainings have been

conducted, and the common data system called the WELS Bay Area Regional RTT

Database was further developed.

o A model infant/toddler quality site served as a “learning community” that promoted early

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

that toddlers in the Starlight Children’s Center were 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 2014-15, the percentage of preschool classrooms taught by SEEDS-trained

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

20% to 93%. Similarly, the percentage of family child care settings that were rated as

having high quality support increased from 44% to 89%.

o Children in classrooms taught by SEEDS-trained early childhood educators are developing

skills in key areas of reading success. In 2014-15 the Santa Cruz Reading Corps placed 14

Literacy Tutors with SEEDS training in 24 state preschool and TK classrooms, serving 601

children. 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 This improvement in English pre-literacy skills was particularly striking among primarily

Spanish-speaking children who had received tailored interventions. Not only did these

Spanish-speaking children improve their skill levels, but by their last assessment they had

increased their scores by a higher amount in Picture Naming and Rhyming. This result

suggests that these children are getting the tailored help they need to increase their

vocabulary and bring them up to a level where they can more fully benefit from the SEEDS

of Early Literacy classroom curriculum with the rest of their peers.

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

additional 1.6 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 2014-2015 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS


PART 1: STRATEGIC FRAMEWORK RESULTS

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT


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, 2014 and June 30,

2015 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.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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 2015, there were 18,824 children

ages 0-5, the majority of whom were either Hispanic (56%), or White (37%). This diversity continues

into kindergarten, where in 2015, 43% 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 (2015)

Figure 3: English Language Proficiency of County Kindergarteners (2014-15)

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 – 2015) 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, December 2014; (English Language Proficiency) California Department of Education, DataQuest, 2014-15.

N: (Ethnicity) N=18,824; (English Language Proficiency) N=3,426.

18,571 18,489 18,518 18,360 18,046 18,327 18,633 18,753 19,019 18,824

10,000

14,000

18,000

22,000

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

55.8%

36.7%

2.5%

0.6%

4.3%

Hispanic

White

Asian/ Pacific Islander

Other

Multirace

56.7%

42.2%

1.0%

English as PrimaryLanguage

English Learners(EL)

Fluent-English-Proficient (FEP)

OVERALL WELL-BEING OF CHILDREN IN THE COUNTY

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT COUNTY TRENDS


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

INDICATOR COUNTY POPULATION CURRENT

DATA1

CHANGE OVER TIME3

1 YEAR 5 YEARS

FINANCIAL WELL-BEING

Unemployment Rate 2

Santa Cruz County (Average monthly rate; fiscal year July-June)

8.0% -1.5 net decrease -5.3

net decrease

(4 year trend)

Watsonville (Average monthly rate; fiscal year July-June)

10.3% -1.8 net decrease -6.5

net decrease

(4 year trend)

Felton (Average monthly rate; fiscal year July-June)

4.0% -0.8 net decrease -2.9

net decrease

(4 year trend)

Median Family Income 4 Families (with children under 18 years) $80,788 +8.2% +10.0%

Living Below the Federal Poverty Level 4

General population 16.8% +1.9 net increase +2.9 net

increase

Children (ages 0-5) 18.2% -1.7 net decrease -4.7 net

decrease

Living Below the Self-Sufficiency Standard 4, 5 Families 59.5% +1.4 net

increase +11.4 net increase

ENROLLMENT IN PUBLIC ASSISTANCE PROGRAMS

CalWORKS General population (Average monthly enrollment; fiscal year July-June)

4,290 -4.4% -20.1%

CalFresh Program (Food Stamps) General population (Average monthly enrollment; fiscal year July-June)

24,787 +5.9% +40.6%

Free and Reduced Price Meals Student population (Annual enrollment; school year July-June)

21,572 -2.2% +12.2%

Women, Infants, & Children Program (WIC) 4

General population (Average monthly enrollment, calendar year)

8,590 -4.8% -7.7%

PRENATAL CARE IN THE FIRST TRIMESTER

Prenatal Care in the First Trimester (by Mother’s Age) 4

All Mothers 80.0% -0.7 net decrease +0.5 net

increase

Mothers (ages 24 and under) 67.6% -0.4 net decrease -3.1 net

decrease

Prenatal Care in the First Trimester (by Payment Method) 4

Private insurance 89.7% -2.0 net decrease -1.3 net

decrease

Medi-Cal insurance 72.2% +0.4 net increase -0.8 net

decrease

TEEN PREGNANCY

Percentage of Births to Teen Mothers 4

Teen mothers (ages 19 and under) 5.6% -0.6 net decrease -4.1 net

decrease

Teen Birth Rate (per 1,000) 4 Teen mothers (ages 15-19) 17.9 +0.1 net increase -1.8 net

decrease

BIRTHS PAID BY MEDI-CAL

Births Paid by Medi-Cal 4 All Mothers 52.9% +1.4 net

increase +1.5 net increase

Mothers (ages 24 and under) 83.4% -0.6 net decrease +4.6 net

increase

1 Current data are for 2015, unless otherwise noted. 2 In January 2015 the U.S. Bureau of Labor Statistics substantially changed the methodology used to calculate unemployment rates and introduced population adjustments

based upon the 2010 Census, which resulted in significant changes to unemployment rates. Only the years that were updated (2010-2015) are included in this analysis. 3 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 of percentages). 4 Data are for 2014. 5 The Self-Sufficiency Standard is a more comprehensive measure of income adequacy than the Federal Poverty Level, as it takes into account the costs of housing, child

care, health care, transportation, food, and taxes, as well as economic differences between counties.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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.8

Figure 4: Number of Services to Children and Parents, by Goal Area (2014-2015)

GOAL AREA

CHILDREN (AGES 0-5)

PARENTS

NUMBER PERCENT NUMBER

(AGES <17)NUMBER

(AGES 17+) TOTAL

NUMBER PERCENT

Healthy Children 1,982 29.5% 0 0 0 0.0%

Strong Families 491 7.3% 1 687 688 93.5%

Children Learning and Ready for School 4,244 63.2% 0 48 48 6.5%

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

6,717 100.0% 1 735 736 100.0%

Unique Number of Clients* (unduplicated number of clients

across all goal areas) 6,328 3 728 731

Source: First 5 CCD database for July 1, 2014 – June 30, 2015.

* 376 children and 5 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 Healthy Kids Initiative, Raising A Reader,

PVUSD-Migrant Education (Summer Pre-K), Side by Side, and the Stanford Neurodevelopmental

Foster Care Clinic.

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,

1,060 parents participated in Triple P parenting Seminars and Workshops;

314 parents participated in Transition to Kindergarten Workshops;

8 In this report, client characteristic data (CCDs) collected via all approved methods—which are then combined and comprehensively

analyzed—are collectively referred to as the “First 5 CCD database.”

PROFILE OF PARTICIPANTS

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PROFILE OF PARTICIPANTS


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

trainings;

763 Kits for New Parents were shipped to clinics, hospitals, service providers, and events

throughout the County, for distribution to individuals.

According to the 2015 population estimates for Santa Cruz County, there were approximately

18,824 children ages 0-5 residing in the County (including 10,508 Latino children).9

During the 2014-2015 fiscal year, partners funded by First 5 served 6,328 unique children,

approximately 34% of all children ages 0-5 in the County.

Among the Latino population, 46% 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 First 5 CCD database, July 1, 2006 – June 30, 2015. (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 2014.

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 parenting workshop, and children benefiting

from service providers who attended customer service trainings.

9 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, December 2014.

31% 30%35%

41%

62%54%

59%

50%46%

23%27% 26% 27%

44%39%

42%36% 34%

0%

20%

40%

60%

80%

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15

Percent of County'sLatino Children 0-5Served by First 5

Percent of County'sChildren 0-5 Servedby First 5

Indicator: Percentage of children 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, and children who reside in South County.

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


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. (2013-2014) Ethnicity = 6,811; Language = 6,807; Region of County = 6,573, (2014-2015) Ethnicity = 6,321; Language = 6,320; Region of County = 6,247.

69.3%

57.8%

76.8%

70.8%

63.8%

77.0%

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%

0% 20% 40% 60% 80% 100%

South County

Spanish as Household Language

Latino

2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

Indicator: Demographic trends in children participating in First 5 programs



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: income relative to the Federal Poverty Threshold,

self-sufficiency, Medi-Cal births, parental unemployment, births to teens, referrals to child welfare

services, child abuse, children who witness domestic violence, adults without a high school degree,

and linguistic isolation. For each indicator, one of four levels of risk was assigned.

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 elementary schools with a

high percentage of English language learners.

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.

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



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, 88% 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 County Children Who Received Services, by ZIP Code (2014-2015)

Figure 9: Number of County Children Who Received Services, by ZIP Code (2014-2015)

AREA ZIP

CODE

CHILDREN SERVED

AREA ZIP

CODE

CHILDREN SERVED

NUMBER PERCENTAGE NUMBER PERCENTAGE

Aptos, Rio Del Mar* 95003 167 2.7% Mt. Hermon 95041 3 0.0%

Ben Lomond 95005 40 0.7% Santa Cruz* 95060 568 9.3%

Boulder Creek 95006 48 0.8% Santa Cruz (Live Oak)* 95062 638 10.5%

Brookdale 95007 2 0.0% Santa Cruz 95064 25 0.4%

Capitola 95010 115 1.9% Santa Cruz 95065 112 1.8%

Davenport 95017 26 0.4% Scotts Valley* 95066 107 1.8%

Felton 95018 41 0.7% Soquel 95073 49 0.8%

Freedom 95019 233 3.8% Watsonville* 95076 3,927 64.4%

Total - 6,101 100% Source: First 5 CCD database for July 1, 2014 – June 30, 2015.

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

Legend

Frequency

Data unavailable

25.00 – 40.999

41.00 – 109.499

109.50 – 232.999

233.00 – 3,927.00



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 2014-15, 69 early childhood educators from preschools and family child care

homes received professional development training from the SEEDS of Early Literacy program, 92

providers attended a Race to the Top (RTT) Workshop and received a stipend, and 23 Family Child

Care providers received a stipend to participate in Race to the Top - Early Learning Challenge

(RTT-ELC). 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 staff

in 57 state and federally funded classrooms and 23 Family Child Care homes who participated in the

Race to the Top – Early Learning Challenge quality improvement efforts; the hundreds of early

childhood educators who provided the Raising A Reader program to children; and the 49 staff/child

care providers who received early childhood and mental health training from Side-by-Side

Clinician/Consultants.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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, results from the Newborn Enrollment Project, and health insurance utilization 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, according to federal,

state, and local surveys, but some families are still experiencing challenges getting insurance for all

of their young children. Over the past year First 5 Santa Cruz County continued 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: (2001-2005) UCLA Center for Health Policy Research, California Health Interview Survey (CHIS); (2009-2014) United State Census Bureau, American Community Survey (ACS), Table B27001, 2014.

93.9%

96.2%94.4% 95.2%

97.2%

91.9%

95.3%

98.7%

93.7%94.5%

93.0% 93.6% 94.2%

94.4%

94.8%96.1%

80%

85%

90%

95%

100%

2001 2005 2009 2010 2011 2012 2013 2014

Santa Cruz County

California

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

HEALTHY CHILDREN

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT HEALTHY CHILDREN


Since 2004, the Healthy Kids

Initiative has helped 16,111

children ages 0-5 apply for

public health insurance

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

Healthy Kids Initiative provides assistance with application and enrollment in public health insurance

to income-eligible families. Through community outreach workers called

Certified Application Assistors (CAAs)10, children from families earning up to

300% of the Federal Poverty Level receive assistance in applying for Medi-Cal

and the local Healthy Kids health insurance plan. Beginning in November 2013,

CAAs also began to assist documented families not eligible for Medi-Cal

programs with applying for Covered California, the California version of the

national Affordable Care Act.

New Enrollments

The following figure presents the number of children ages 0-5 newly enrolled in health

insurance through the assistance of CAAs. Across the years since the effort began in 2004, CAAs

have helped 16,111 children ages 0-5 apply for public health insurance.11

Several factors have affected enrollment numbers over the years:

o The large increase in Medi-Cal enrollments in 2009-10 is attributable to the Newborn

Enrollment Project (described subsequently).

o With the introduction of the Affordable Care Act (ACA), individuals and families in California

now had the opportunity to obtain health insurance through California’s new health

insurance exchange, called Covered California. Beginning on January 1, 2014, children (0-5

and 6-18) who were now eligible for coverage under Covered California were disenrolled

from Healthy Kids. Consequently, the enrollment numbers in Healthy Kids and other public

health insurance plans decreased as families took advantage of these new opportunities and

accommodated the changing eligibility requirements of these various plans.

o Enrollment numbers for 2013-14 are also lower than usual due to changes in the timing of

data collection. In prior years, enrollment results represented the status of children’s

applications 2-3 months after the end of the fiscal year (to allow time for the most newly-

submitted applications to be evaluated and “settled”). In 2013-14, data were only

available as of the end of the fiscal year and therefore do not reflect the status of

applications after this 3-month “settling” period.

o Due to changes in reporting capabilities, 2014-15 numbers reflect the number of new

applications that were completed with assistance from CAAs, but do not necessarily

reflect the number that were accepted and enrolled.

10

In this report, the title “CAA” is used to refer to both CAAs and also individuals who are certified as Certified Enrollment Counselors (CECs), which is a title is specific to counselors providing Covered California services.

11 First 5 Santa Cruz County, Healthy Kids Program database, 2014-2015.

Indicator: Number of children ages 0-5 in Santa Cruz County who are assisted in applying for publicly-funded health insurance



Figure 11: Number of Children (Ages 0-5) Newly Enrolled in Publicly-Funded Health Insurance Programs (with Assistance from First 5-funded CAAs)

Source: (2006-2014) County of Santa Cruz Health Services Agency, CBT Benefit Status Master Totals Report and Newborn Benefit Status Report, 2014. (2014-15) First 5 Apricot database, Healthy Kids Program, 2015. * Due to changes in reporting capabilities, 2014-15 numbers reflect the number of new applications that were completed with assistance from CAAs, but do not necessarily reflect the number that were accepted and enrolled.

Baby Gateway—the Newborn Enrollment Project—operates in three local hospitals with funding and

support provided by First 5 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 are offered 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 2014-15 show how successful this program has been in providing these services to Santa

Cruz County mothers and newborns.

Of all 3,107 births that occurred in Santa Cruz County hospitals in 2014-15, 87% of mothers

received a newborn visit while in the hospital, and 67% accepted a “Kit for New Parents.”

Of all 1,704 mothers with Medi-Cal births, 70% were assisted to complete a Medi-Cal

application for their new babies.

580519

620

1,312

1,741

2,185

1,871

1,413 1,387

53 42 67

901

1,226

1,681 1,609

1,385 1,364

175 118158

96 70 7557 28 18

352 359 395315

445 429

205

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 2013-14 2014-15*

Total

Medi-Cal

Healthy Kids

Healthy Families

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



Of the mothers who were assisted with Medi-Cal applications for their newborns, 80%

identified a preferred primary care provider (PCP) or clinic for their child before discharge from

the hospital, and were helped by the CAAs to schedule the first appointment for the newborn.

Figure 12: Newborn Enrollment Project Statistics (2014-2015)

PROGRAM COMPONENT WATSONVILLE

COMMUNITY

HOSPITAL

DOMINICAN

HOSPITAL SUTTER MATERNITY

& SURGERY CENTER

OF SANTA CRUZ TOTAL

Total Number of All Births in Santa Cruz County hospitals

1,239 848 1,020 3,107

Total Number of Newborn Visits (regardless of insurance status) 1,109 817 780 2,706 87.1%

Number of Kits for New Parents Distributed 729 686 656 2,071 66.7%

Total Number of Medi-Cal Births 1,061 386 257 1,704

Number of Completed Newborn Medi-Cal Applications

592 377 221 1,190 69.8%

Number of Newborn Medi-Cal Applicants who have identified a Preferred Primary Care Provider or Clinic for their newborn, before discharge

1

408 348 196 952 80.0%

Source: (Births) Santa Cruz County Public Health, 2015. (Visits, Kits) First 5 Santa Cruz County, Baby Gateway records, 2015. (Application data) First 5 Apricot database, Healthy Kids Program, 2014-2015. 1 Before FY 2013-14, this reflected the number of applicants who were assigned a primary care provider (PCP) by a CAA before discharge from the hospital. As of FY 2013-14, the Central California Alliance for Health now calls the patients after discharge from the hospital to assign them a PCP, so the CAAs are no longer able to track these assignments. However, the data collection system allows CAAs to record the number of applicants who have identified a preferred PCP or clinic before discharge from the hospital, and these results are presented here.



Increase Use of Medical/Dental Homes

The majority of County children enrolled in Healthy Kids, ages 2-6, had a medical home. In 2014,

84% of children had access to a primary care practitioner, which is lower than the average trend

over the past several years. This drop may reflect the different population of children enrolled in

Healthy Kids in 2014.12

Figure 13: Percentage of County Children Enrolled in Healthy Kids (Ages 2-6) Who Had Access to a Primary Care Practitioner

Source: Central California Alliance for Health, HEDIS Results: 2006-2014. N: (2006)=227, (2007)=221, (2008)=227, (2009)=208, (2010)=164, (2011)=134, (2012)=107, (2013)=104, (2014)=37.

Parents of children receiving enrollment services through First 5-funded CAAs were asked when they

renewed their children’s insurance whether their children had used the benefit during the previous

year. During the 2014-2015 year, nearly all children (95%) who received renewal assistance in a

public insurance program had utilized their benefits prior to their renewal, continuing the trend of

high utilization across the years.

Figure 14: Percentage of Children (Ages 0-5) Who Utilized Health Care Prior to Renewal in an Insurance Program (renewed through First 5-funded CAAs)

Source: (2006-14) Health Care Outreach Coalition, Annual Progress Report, 2007-14. (2014-15) First 5 Apricot database, Healthy Kids Program, 2015.

Note: Prior to 2013-14, results represented the status of children’s applications 2-3 months after the end of the fiscal year (to allow time for the most newly-submitted applications to be evaluated and “settled”). For 2013-14, data were only available as of the end of fiscal year and do not reflect the status of applications after this 3-month “settling” period. Utilization results exclude clients with missing data. * Methodological changes at certain agencies reduced how consistently the utilization questions were asked of renewing clients, and these agencies have been omitted from this analysis. N: (2006-07)=471, (2007-08)=514, (2008-09)=555, (2009-10)=789, (2010-11)=829, (2011-12)=1,013, (2012-13)=1,102, (2013-14)=522, (2014-15)=138.

12

Due to Health Care Reform, by January 1, 2014 all children eligible for subsidized coverage under Covered California were moved from Healthy Kids to Covered California, leaving undocumented children as the primary client population for Healthy Kids.

89.9% 90.1%93.8% 89.4%

95.1% 94.0% 97.2% 93.3%

83.8%

50%

60%

70%

80%

90%

100%

2006 2007 2008 2009 2010 2011 2012 2013 2014

99.6% 97.9% 99.6% 99.4% 96.6%99.6% 99.0% 97.3% 94.9%

50%60%

70%80%90%

100%

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15*

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 2014, the majority of children ages 2-6 enrolled in Healthy Kids (73%) had a dental visit

within the past year.

In 2011, 84% of Santa Cruz County families surveyed as part of the local

Community Assessment Project said that at least one of their children

ages 0-5 had dental insurance.

Clearly, 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.

Figure 15: Percentage of County Children Receiving Dental Care

Percentage of County Children (Ages 2-6) Enrolled in Healthy Kids

Who Had a Dental Visit Within the Past Year

Source: Central California Alliance for Health, HEDIS Results: 2006-2014.

N: (2006)=227, (2007)=222, (2008)=227, (2010)=164, (2014)=37.

Note: HEDIS dental data were not collected every year. Years with no data have been left blank.

County Families and the Dental Insurance Status of their Young Children (0-5) (2011)

“How many of your children have dental insurance?”

Source: Applied Survey Research, Santa Cruz County Community Assessment Project (CAP), 2012. N=107 families. 2011 is the most current year with available CAP data at the time of this report.

Figure 16: 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. 2007 is the most current year with available data at the time of this report.

64.8%67.6%

75.8%85.4%

73.0%

0%

20%

40%

60%

80%

100%

2006 2007 2008 2009 2010 2011 2012 2013 2014

15.9%

84.1%

0%

20%

40%

60%

80%

100%

No child (0-5) hasdental insurance

At least one child (0-5)has dental insurance

189 222 203

0

100

200

300

2005 2006 2007

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

“Most children who end

up in the ED for

preventable dental

conditions are ages five

and under.”

- California HealthCare Foundation



Increase Use of Preventive Health Services

In 2014, the majority of children ages 3-6 enrolled in Healthy Kids (65%) received a well-child visit

with their pediatrician, which is lower than the average trend over the past several years. This drop

may reflect the different population of children enrolled in Healthy Kids in 2014.13

Figure 17: Percentage of County Children (Ages 3-6) the County Enrolled in Healthy Kids Who Received a Well-Child Visit

Source: Central California Alliance for Health, HEDIS Results: 2006-2014.

N: (2006)=210, (2007)=207, (2008)=211, (2009)-191, (2010)=152, (2011)=117, (2012)=97, (2013)=89, (2014)=34.

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, particularly at Watsonville

Community Hospital.

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

comparing data for the year prior to the launch (2008) to the most current year (2014), the

number of ED visits for infants under age 1 has decreased 40%.

Baby Gateway was launched at Dominican Hospital in January 2011. Between the year prior

(2010) and the most current year (2014), ED visits for infants under age 1 has stayed

relatively level, with a slight decrease of 4%.

13

Due to Health Care Reform, by January 1, 2014 all children eligible for subsidized coverage under Covered California were moved from Healthy Kids to Covered California, leaving undocumented children as the primary client population for Healthy Kids.

78.1% 81.6% 76.8% 79.6% 82.9% 87.2% 84.5%78.7%

64.7%

0%

20%

40%

60%

80%

100%

2006 2007 2008 2009 2010 2011 2012 2013 2014

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



Figure 18: Number of Emergency Department Visits (Infants Less Than One Year Old)

Source: State of California, Office of Statewide Health Planning and Development (OSHPD), Healthcare Information Division, Emergency Department Pivot Profiles and customized reports, 2015.

Increase Number of Children Reaching Developmental Milestones

In 2014-15, 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 19: 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, (2013-14)=3,334, (2014-15)=3,426.

2,2092,102

2,315

1,926

1,600 1,5661,526

1,268

617 655 724629 587

522 542 603

0

400

800

1,200

1,600

2,000

2,400

2007 2008 2009 2010 2011 2012 2013 2014

WatsonvilleCommunity Hospital

Dominican Hospital

6.6% 6.3%5.5%

6.0% 6.0%7.1% 7.2% 7.0%

6.5%

0%

2%

4%

6%

8%

10%

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15

Baby Gateway Launched at

Dominican Hospital

Baby Gateway Launched

at Watsonville Community

Hospital



The Stanford Neurodevelopmental Foster Care Clinic (“SNDFCC”) is an innovative, coordinated

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

foster care system. SNDFCC and its interdisciplinary team provides 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 SNDFCC collects key data regarding the population they serve, and the following charts provide

a profile of the child population that received services, and the types of referrals that were made

after assessments. Data from the past four fiscal years (2011-2015) have been aggregated in order

to present a more robust profile of the children served.

Figure 20: Demographics of the Children (Ages 0-5) Participating in the SNDFCC (2011-2015)

Gender Primary Language

Race/Ethnicity Age

Source: Stanford Neurodevelopmental Foster Care Clinic, Data Template, 2011-2015. N: (Gender, Race/Ethnicity, Age)=296; (Language)=295.

Male46.6%

Female53.4%

English90.2%

Spanish9.8%

Latino / Hispanic,

54.1%

Caucasian / White, 39.5%

Other, 6.4% 13.9%

28.7%

16.6%

12.8%

13.5%

14.5%< 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 21: Percentage of Children in SNDFCC (Ages 0-5) With These Diagnoses and Services, at Intake (2011-2015)

Source: Stanford Neurodevelopmental Foster Care Clinic, Data Template, 2011-2015. Note: Data for different diagnoses and services were not always collected every year. Therefore, the number of children analyzed for each diagnosis and service may vary. Only diagnoses and services with percentages higher than 4% for at least one age group are shown. N: Ages 0-2 (IEP, ADHD, Occupational Therapy, Developmental Disability Services)=175; (Delayed, Severely Delayed)=168; (COMH Counselor)=73; Ages 3-5 (IEP, ADHD, Occupational Therapy, Developmental Disability Services)=121; (Delayed, Severely Delayed)=120; (COMH Counselor)=32. * 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. ** COMH = County Office of Mental Health

Figure 22: Percentage of Children in SNDFCC (Ages 0-5) Provided With These Referrals (2011-2015)

Source: Stanford Neurodevelopmental Foster Care Clinic, Data Template, 2011-2015.

Note: Data for different referrals were not always collected every year. Therefore, the number of children analyzed for each referral may vary. Only referrals with percentages higher than 4% for at least one age group are shown.

N: Ages 0-2 (School district, Developmental Disability Services, Triple P, Audiology, Occupational Therapy)=175; (Behavior Management, Leaps & Bounds counselor)=73; (Head Start/Early Head Start)=97. Ages 3-5 (School district, Developmental Disability Services, Triple P, Audiology, Occupational Therapy)=121; (Behavior Management, Leaps & Bounds counselor)=32; (Head Start/Early Head Start)=53

* The Leaps & Bounds program is designed to support the healthy development of children ages 0-5 whose parents are recovering from methamphetamine or other drug use and who are participating in the County’s Dependency Drug Court Program.

25.0%

1.8% 2.9%1.4%

4.6% 4.6%

36.7%

13.3%11.6%

6.3% 5.0%

0%

10%

20%

30%

40%

"Delayed"Developmental

Level*

"Severely Delayed"Developmental

Level*

At Risk for ADHD Has a COMHCounselor**

Has an IEP ReceivingOccupational Therapy

ReceivingDevelopmental

Disability Services

Ages 0-2 Ages 3-5

0.6%

8.6%

3.1% 3.4% 2.7%4.6%

6.8%4.0%

31.4%

6.6% 7.5% 6.6% 6.3%2.5% 2.5%

0%

10%

20%

30%

40%

School district(IEP/IFSP

development)

DevelopmentalDisability Services

Head Start/EarlyHead Start

OccupationalTherapy

BehaviorManagement

Triple P (Parentingskills)

Leaps & BoundsCounselor*

Audiology

Ages 0-2 Ages 3-5

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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 6.8 (per 1,000) in 2014. The decreasing rates in Santa Cruz

County may have been assisted by the efforts of the Families Together program and the countywide

Triple P – Positive Parenting Program, which launched in late 2006 and 2009, respectively.

Figure 23: Rate of Substantiated Allegations of Child Maltreatment in Santa Cruz County and California (per 1,000)

Needell, B., Webster, D., Armijo, M., Lee, S., Dawson, W., Magruder, J., Exel, M., Cuccaro-Alamin, S., Putnam-Hornstein, E., King, B., Morris, Z., Sandoval, A., Yee, H., Mason, F., Benton, C., & Pixton, E. (2015). CCWIP reports. Retrieved 6/25/2015, from University of California at Berkeley California Child Welfare Indicators Project website. URL: <http://cssr.berkeley.edu/ucb_childwelfare>

11.6 11.5 11.3 11.210.2 9.9

9.6

9.5

9.3 9.2 9.0

16.2 15.7

13.714.4

12.2

10.2

8.8

11.0

7.9 7.36.8

0

2

4

6

8

10

12

14

16

18

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

California

Santa Cruz County

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

Strong Families

STRONG FAMILIES

Families Together

Launched 9/2006 Triple P

Launched 11/2009

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2014-2015 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). 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, 64% of families were assessed as

being “high risk” or “very high risk” upon intake, and this dropped to 13% by the second

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

Figure 24: Change in Families’ Risk Levels During Participation in the Families Together Program (July 2007 – June 2015)

Source: First 5 Apricot database, Structured Decision Making: Family Prevention Services Screening Tool (SDM:FPSST) data, 2007-2015.

* 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.

31.7%37.3%35.8%

48.4% 49.3%48.2%

16.5%

9.1%16.0%

3.5% 4.3%

0%

10%

20%

30%

40%

50%

60%

70%

Baseline* (N=589) 1st Reassessment (N=461) 2nd Reassessment (N=209)

Low Risk

Moderate Risk

High Risk

Very High Risk

Indicator: Percentage of Families Together participants at each level of risk, baseline to reassessment



Of the 66 families who received services from Families Together and had their cases closed in the

2014 calendar year:

94% 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 20% 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.

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.

Indicator: Percentage of Families Together participants with substantiated allegations of child maltreatment within 6 months of program completion



First 5 continued to implement its Triple P social marketing campaign with the assistance of Miller

Maxfield, a local communications firm, in order to reach a broad population of parents, including

those who are less likely to seek support from a social service agency. The 2014-15 campaign

activities built on the previous year’s efforts to increase awareness about the benefits and availability

of the Triple P program in Santa Cruz County. Key campaign activities included:

Branding & Messaging: Continued to raise awareness of Triple P through earned media, paid

advertisements, event sponsorships, social media, and video PSAs

Web site: Received 313 online registrations for Triple P classes

Triple P Warmline/Email/Facebook: Received 103 requests for Triple P information and

services

Parenting Pocket Guides: Distributed approximately 8,500 bilingual Triple P parenting 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 501 new fans

Positive Parenting Passport: Developed “passport” program to engage parents in Triple P

and positive parenting activities; Partnered with local businesses to sponsor prizes

Earned Media: Received free media coverage of Triple P classes and articles 157 times

Ads & Sponsorships: Promoted Triple P via bus ads, Highway 17 billboard, newspaper ads,

and sponsorship of Santa Cruz Warriors Kids' Dunk and Santa Cruz Children's Museum of

Discovery Mobile Museum

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.

Indicator: Level of community members’ engagement in Triple P social marketing and outreach activities

Indicator: Percentage of parents experiencing high levels of distress who demonstrate improvement in one or more key parenting domains



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 both parents of adolescents (who participated in “Teen” Triple P), and

parents of children with special needs (who participated in “Stepping Stones” Triple P). These results

suggest that Triple P was particularly effective for parents who entered the program with more

serious parenting issues.

Figure 25: Impact of Triple P on Parents with More Serious Parenting Issues

Percentage of Parents Who Demonstrated Improvement in These Key Parenting Issues (2010-2015)

Source: Triple P assessment results (analyzed by Applied Survey Research), 2015. (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=742, Clinical=363; (Style) All=844, Clinical=186, (Depression) All=908, Clinical=235; (Anxiety) All=907, Clinical=304; (Stress) All=907, Clinical=242.

Percentage of Parents Who Moved Out of the “Clinical Range” in These Key Parenting Issues (2010-2015)

Source: Triple P assessment results (analyzed by Applied Survey Research), 2015. (Child behavior) ECBI, Problem subscale; (Laxness, Over-reactivity, Hostility) Parenting Scale; (Depression, Anxiety, Stress) DASS-21.

N: (Child behavior)=363; (Laxness) =329; (Over-reactivity) =292; (Hostility)=186; (Depression) =235; (Anxiety) =304; (Stress) =242.

80.2% 77.4%

55.0% 52.7%62.7%

91.7%81.7% 85.5% 86.5% 90.1%

0%

25%

50%

75%

100%

Perception of child'sbehavior

Overall parenting style Depression Anxiety Stress

All Parents Clinical Range at Pre-test

71.1%64.1% 68.8%

78.5%62.6% 62.2%

77.3%

0%

25%

50%

75%

100%

Perception ofchild's behavior

Laxness Over-reactivity Hostility Depression Anxiety Stress



Improvements in Selected Parenting Issues Comparison of Clients in Core Triple P (families with children 0-12)

and Teen Triple P (families with children 13-16) (2010-2015)

Number of problems with their partners over parenting

Stress

Over-reactive parenting style Anxiety

Source: Triple P data from the Parent Problem Checklist, the Depression, Anxiety, Stress Scale – Short Version (DASS-21), and Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 - June 2015. * 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). *** When there were separate Clinical Cut-offs for Males and Females, this has been taken into account in each analysis so that results could be reported overall. In these instances, the separate Cut-off levels for each gender that are shown in the charts are for illustration purposes only.

5.9 7.0

3.7 4.1

0

4

8

12

16

Core**(N=491)

Teen**(N=49)

Pre Post

13.4 15.7

9.010.9

0

7

14

21

28

35

42

Core*(N=795)

Teen*(N=66)

Pre Post

3.54.0

2.93.2

1

2

3

4

5

6

7

Core*(N=732)

Teen**(N=67)

Pre Post

7.9 8.45.1 5.10

7

14

21

28

35

42

Core*(N=795)

Teen*(N=66)

Pre Post

Less over-reactive

Lower is

“Better”

Clinical Cut-Off:*** Female >= 4.0 Male >= 3.9

More over-reactive

Lower is

“Better” Clinical Cut-Off:

>5

All issues were a problem

No issues were a problem

Extremely severe distress

No distress

Lower is

“Better”

Clinical Cut-offs:

Very Severe >=34

Severe >=26

Moderate >=19


No distress

Lower is

“Better”

Clinical Cut-offs:

Very Severe >=20

Severe >=15

Moderate >=10




and Stepping Stones Triple P (families with children who have special needs) (2010-2015)

Lax parenting style Stress

Number of child behaviors perceived to be a problem

Depression

Source: Triple P data from the Parenting Scale, ECBI, and the Depression, Anxiety, Stress Scale – Short Version (DASS-21), analyzed by Applied Survey Research, Jan. 2010 - June 2015. * 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). *** When there were separate Clinical Cut-offs for Males and Females, this has been taken into account in each analysis so that results could be reported overall. In these instances, the separate Cut-off levels for each gender that are shown in the charts are for illustration purposes only.

3.2

4.0

2.6 2.6

1

2

3

4

5

6

7

Core**(N=733)

Stepping Stones**(N=11)

Pre Post

13.4 14.7

9.06.7

0

7

14

21

28

35

42

Core*(N=795)


Pre Post

14.3

19.4

7.411.0

0

6

12

18

24

30

36

Core**(N=645)


Pre Post

9.46.96.0

2.40

7

14

21

28

35

42

Core*(N=796)


Pre PostAll behaviors were a problem

No behaviors were a problem

Clinical Cut-off:

>=15

Lower is

“Better”

More lax

Less lax

Lower is

“Better”

Clinical Cut-Off:*** Female >= 3.6

Male >= 3.4

No distress

Lower is

“Better”

Clinical Cut-offs:

Very Severe >=34

Severe >=26

Moderate >=19

Lower is

“Better”


No distress


Clinical Cut-offs:

Very Severe >=28

Severe >= 21

Moderate >=14



Parents who participated in in-depth Triple P services completed 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 to 7, 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.

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 26: Parents’ Use of Positive Parenting Styles (2010-2015)

Source: Triple P data from the Parenting Scale, Overall scores, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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 less positive 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).

Continued Use and Effectiveness of Triple P: A Follow-up Phone Survey

As part of its process of continuous quality improvement, First 5 Santa Cruz County commissioned a

phone survey of Triple P participants—conducted in July 2015—to better understand the efficacy of

Triple P among local families, how participants are using Triple P strategies, how services may be

improved, as well as how Triple P can reach more families in the county who may benefit from

services.14

o On average, survey participants had last participated in Triple P services 10 months prior

to the interview. Of these, 95% reported they continue to use strategies learned from

Triple P.

14

The full report is available from First 5: Applied Survey Research, Triple P Santa Cruz County: Participant Pathways and Perspectives, 2015.

3.23.1

3.3 3.43.0

3.5

3.13.1

2.6 2.6 2.6 2.72.4

2.82.5 2.6

1

2

3

4

5

6

7

All Parents**(N=810)

Male**(N=230)

Female**(N=580)

Latino**(N=433)

Caucasian**(N=307)

Spanish**(N=298)

English**(N=496)

Child WelfareInvolved**

(N=188)

Pre Post

Indicator: Use of positive parenting styles

Less positive

More positive

Lower is

“Better”



o When asked how frequently they used the skills they’d learned, a high percentage of

participants from all levels of Triple P reported that they used them “Every day” or

“Almost every day.” The highest percentages of participants who reported daily or almost-

daily use of strategies had participated in in-depth Individual services (63%), in-depth

Group services (56%), Workshops (54%), and Seminars (45%).

Frequency of Continued Strategy Use, by Type of Triple P Service Received

Source: Applied Survey Research, Triple P Santa Cruz County: Participant Pathways and Perspectives, 2015.

o The most helpful skills and strategies mentioned by survey participants were in the areas

of communication skills, assertive discipline, emotion regulation, and creating structure.

Most Helpful Strategies and Skills Learned


N-124.

o Overall, a vast majority of survey participants reported experiencing significant and lasting

benefits of Triple P services. They reported an overwhelmingly positive experience with

the program, learned strategies they could use regularly in their parenting, and nearly all

participants were likely to recommend the services to family and friends.

3%10% 7% 5% 4% 6% 6%

9%5% 10% 16%

2% 3% 6%

44% 31%

50%53%

30%35%

44%

24%

27%

7%

11%

24%

32%17%

21% 27% 27%16%

39%24% 28%

0%

20%

40%

60%

80%

100%

Level 2Seminar(N=35)

Level 3Workshop

(N=63)

Level 3(Brief)

Individual(N=31)

Level 3(Brief)Group(N=19)

Level 4(In-depth)Individual

(N=46)

Level 4(In-depth)

Group(N=34)

Level 5(Additional

support)(N=18)

Every day

Almost every day

A few times a week

Less than once a week

Never

2

3

5

7

11

13

20

22

25

38

Other

Co-parenting

Expectations

Self-care

Family cohesiveness

Listening skills

Structure & routines

Emotion regulation

Assertive discipline

Communication skills

Number of times mentioned by survey participants



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 who participated in in-depth Triple P services completed 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 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 Females, Latinos, and Spanish-speaking parents.

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.

Figure 27: Number of Child Behaviors Perceived to Be a Problem (2010-2015)

Source: Triple P data from the Eyberg Child Behavior Inventory: Problem subscale, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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 two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

14.4

21.8

12.215.3 15.5

13.116.3

13.1 9.67.4

10.6

6.4 7.7 7.77.2

8.56.6 5.8

0

6

12

18

24

30

36


ClinicalRange at

PreTest**(N=352)

Male**(N=200)

Female**(N=512)

Latino**(N=393)

Caucasian**(N=255)

Spanish**(N=278)

English**(N=421)

ChildWelfare

Involved**(N=158)

Pre Post

Indicator: Report of child behavior problems

All behaviors were a problem


Clinical Cut-off:

>=15

Lower is

“Better”

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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 2014-2015 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL


RACE TO THE TOP – EARLY LEARNING CHALLENGE GRANT CHILD SIGNATURE PROGRAM

Number of Sites/Classrooms

2012-2015

46 sites at:

o Cabrillo College

o Campus Kids Connection

o Community Bridges

o Encompass Community Services - Head Start & State Preschools

o Live Oak School District

o Pacific Elementary School District

o Pajaro Valley Unified School District

o UCSC

o Walnut Avenue Women’s Center

o YWCA of Watsonville


17 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 26 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

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



assigned to each tier for seven elements of quality, such as teacher-child ratios, teacher

qualifications, and teacher-child interactions. Sites receive a rating based on their cumulative scores

in all seven elements, 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.










Figure 28: Ratings of QRIS Sites in Santa Cruz County

NUMBER OF SITES WITH THIS RATING

QUALITY TIER DEC. 2013 PROVISIONAL RATINGS DEC. 2014 PROVISIONAL RATINGS

Tier 1 0 0

Tier 2 0 23

Tier 3 24 17

Tier 4 16 28

Tier 5 0 1

Total sites 40 69 Source: First 5 Santa Cruz County, 2015. Note: The initial ratings of Santa Cruz County’s sites are considered to be “Provisional” rather than “Full,” since no sites had yet received both an independent Classroom Assessment Scoring System (CLASS) AND Environmental Rating Scale (ERS) assessment as of December 2014.

First 5 contracted with Encompass Community Services to lead the QELI Consortium’s quality

improvement activities for center programs, 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 Community Services coordinated trainings related to CSP and RTT-

ELC, provided technical assistance to program directors, maintained centralized records,

coordinated independent assessments, and conducted the QRIS ratings. First 5 contracted with Go

Kids, Inc. to lead the QELI Consortium’s quality improvement activities for Family Child Care (FCC)

homes. The Go Kids, Inc. FCC manager recruited FCC providers to RTT-ELC, completed provisional

baseline ratings, and coordinated trainings and independent assessments.













9 directors














Santa Cruz County has joined with Santa Clara, San Francisco, Alameda, Contra Costa, and San

Mateo counties to form the Bay Area Quality Early Learning Partnership (BAQELP). This regional

consortium was developed so that these neighboring counties could strategize together, share

resources, leverage funds, and align practices. This regional approach has resulted in strengthening

the current resources available for professional development and independent assessment.

The counties in this consortium continue to develop and share a common data system called the

WELS Bay Area Regional RTT Database, which is 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.

Indicator: Local QELI resources are leveraged through participation in regional partnerships



The Starlight Children’s Center (SCC) provided early childhood and family development services to

families of children 0-3 years old, and offered a wide variety of comprehensive bilingual services for

expectant parents and families with infants and toddlers. It was 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 was to create a “learning community” that

promoted early literacy and social/emotional skills to help lay a solid foundation for school readiness.

The program provided center-based services for 10 children, through collaborative funding with the

Early Head Start Program, and operated four days per week for six hours per day. In addition, the

program provided 20 families with home-based services which included weekly home visits and two

socializations per month. Both center- and home-based services followed the criteria for the

federally funded Early Head Start program, and SCC families received priority enrollment into Head

Start pre-school classes once the child turned three years old.

Population Served

2014-2015

Parents/Guardians (Total) 48

(Pregnant clients) 2(Parents/Guardians) 46

Children (Total) 32

(Center-based) 9(Home-visited) 23

Source: First 5 CCD database for July 1, 2014 – June 30, 2015; Starlight Children’s Center, Annual Progress Report, 2015.

At the Starlight Children’s Center, center staff and home visitors worked with parents of infants and

toddlers to build the foundations for literacy. To guide their efforts with children and their families, they

assessed children’s health and development using the Ages and Stages Questionnaire (ASQ) and ASQ:

Social/Emotional (ASQ:SE) screening tools, the DRDP – Infant/Toddler (2010) for children who received

center-based services, and the New Portage Guide for children who received home-based services.

Key Results

Assessment results from the DRDP-I/T showed that toddlers in the Starlight Children’s Center

were supported to develop social and interpersonal skills, and to develop a strong foundation

for later literacy. Children demonstrated similar amounts of improvement in all five areas of

the DRDP-I/T (“Motor and Perceptual Development,” “Health,” “Self and Social

Development,” “Language and Literacy,” and “Cognitive Development”).

For children who completed the New Portage Guide assessment, those ages 9-18 months

showed the greatest growth in “Exploration/approaches to learning.” For children between

the ages of 18-36 months the greatest growth was in “Social/emotional development” and

“Sensory organization.”

Indicator: Model infant/toddler quality site served as a “learning community” that promoted early literacy and social/emotional skills critical for school success



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.” 15

Proficiency in English/Language Arts

STAR test results over time. In 2012-13, 36% of third-graders in Santa Cruz County scored at the

“proficient” or “advanced” performance levels on the STAR

English/Language Arts (ELA), with very little change over the past few

years. However, one area of the county with historically low

performance showed notable improvements in scores, with Pajaro

Valley Unified School District (PVUSD) increasing from 21% in 2007 to

24% in 2013.

Figure 29: Percentage of 3rd Grade Students Performing at the Proficient/Advanced Levels In English/Language Arts

Source: California Department of Education, STAR Test Results, 2007-2013. No new data are available.

Note: The goal in California is to have all students perform at the proficient or advanced level.

15

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%

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

Indicator: Percentage of 3rd grade students in the County at proficient levels in English language development

“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



Baseline CAASPP test results. As of 2013-14, the STAR ELA performance results were no longer available,

as California transitioned to the California Assessment of Student Performance and Progress (CAASPP), a

component of the California Smarter Balanced Assessment System. In spring 2014 California began a

field test of these assessments, and the first statewide administration of these assessments took place in

spring 2015. The first year of English language arts/literacy results are presented below.

Results from the CAASPP show that:

In 2015, 33% of 3rd grade students in Santa Cruz County met or exceeded standards in English

language arts/literacy, compared to 38% of California 3rd graders, which demonstrates the

need to further assist students’ acquisition of these basic literacy skills.

Regarding these new test results, the California Department of Education states that “because these new

exams are based on more challenging academic standards [than the previous STAR assessments], the

results are too fundamentally different to compare to old scores. Instead, these scores are a starting

point—a baseline for the progress students will make over time.”

Figure 30: Achievement Levels of 3rd Grade Students In English Language Arts/Literacy (2015)

Source: California Department of Education, California Assessment of Student Progress and Performance Reports (CAASPP) Test Results, 2015.

English proficiency among English Language Learners

In 2013-14, First 5 began tracking English language proficiency among students whose primary language

is other than English, as measured by the California English Language Development Test (CELDT). This

test is given to students whose home language is not English, and helps schools identify students who

need to improve their skills in listening, speaking, reading, and writing in English.

Results from the CELDT show that:

In the last two years, 21% of County students who were English learners were performing at

the Advanced/Early Advanced levels in English Language Development, in 3rd grade.

Although this County percentage is lower than the State’s (31%), it has been increasing over

the past several years (net change of 9% since 2005-07).

36% 40%52%

26%27%

29%20% 18%

12%18% 15% 7%

0%

20%

40%

60%

80%

100%

California Santa Cruz County PVUSD

Standard Exceeded

Standard Met

Standard Nearly Met

Standard Not Met



Pajaro Valley Unified School District (PVUSD), an area of the county with historically low

performance, showed similar improvements in scores (net change of 10% since 2005-07).

Figure 31: Percentage of 3rd Grade Students—Who are English Learners—Performing at the Early Advanced/Advanced Levels In English Language Development

Source: California Department of Education, California English Language Development Test (CELDT) Test Results, 2007-2015.

Note: Averages are shown for two-year periods, in order to increase the sample size and reduce the variance within smaller populations.

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 proficiency,

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.

Since 2007, First 5’s Early Literacy Foundations Initiative has 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 early

childhood educators working in center and family child care settings.

Developed and expanded the new Santa Cruz Reading Corps. In this program, AmeriCorps

volunteers are trained in the SEEDS of Early Literacy curriculum, work with the classroom

teaching staff to enhance daily literacy opportunities, and conduct literacy assessments to

provide individualized support, with the goal of developing children’s early literacy skills in

English in preparation for kindergarten.

20.7%

26.1%27.4%

32.9%

31.2%

11.7%

16.9%

17.3%

20.4% 21.0%

9.4%

16.8% 15.1%

19.0%

19.5%

0%

5%

10%

15%

20%

25%

30%

35%

2005-2007 2007-2009 2009-2011 2011-2013 2013-2015

California

Santa Cruz County

PVUSD



Encouraged family engagement in literacy activities through continuation of the Raising A

Reader program.

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. Early childhood educators are taught to use the 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 classroom 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.

Santa Cruz County’s SEEDS of Early Literacy program has 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. In 2014-15 First 5 Santa Cruz County offered

SEEDS programs to two different populations of early childhood educators:

SEEDS for Center-based Pre-K and TK Teachers

This program provides professional development for early childhood educators working in Pre-K and

Transitional Kindergarten (TK) centers. In an effort to support teachers as they work to include the

SEEDS concepts into daily practice, this nine-month course is designed to focus on the SEEDS strategies

through embedded and explicit instruction, modeling, practice, and one-on-one coaching throughout

the academic year.

Each participant in SEEDS for Center-based Pre-K/TK receives:

16 three-hour instructional sessions Pre and Post literacy environment assessment

12 two-hour on-site coaching visits 4 literacy labs and 6 children’s books to use in their centers 2 optional literacy labs

SEEDS for Family Child Care Providers

This program provides professional development for family child care providers working with

Spanish speaking children through SEEDS of Early Literacy training and coaching. The training uses

the SEEDS Parent curriculum, with a focus on working with children from birth to kindergarten. This

program offers five Make and Take workshops in the fall, and again in the summer for migrant

providers (beginning in June).

Each workshop includes:

1½ hours of instruction 5 one-on-one coaching sessions in the home

2½ hours to create literacy-based materials to use in the family child care home

Pre and post literacy environment assessments 5 children’s books to use in their program

1 model SEEDS classroom/FCC home tour



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), with the goal of

training and placing AmeriCorps volunteers in state preschool and transitional

kindergarten classrooms in both the Live Oak and Pajaro Valley Unified School

Districts. The SCRC is modeled after the Minnesota Reading Corps, the largest

single state AmeriCorps initiative in the country.

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 proficiency, 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 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 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 2014-15, and cumulatively since 2007.

Figure 32: Number of Early Childhood Educators Who Have Completed SEEDS Trainings

THIS

FUNDING

CYCLE

2014-2015

CUMULATIVE

TOTALS

2007-2015

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

15 53

Number of early childhood educators attending SEEDS of Early Literacy courses 40 455

Number of early childhood educators attending the SEEDS Plus program* 0 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 14 29

TOTAL (unduplicated) 69 639**

CHILDREN

Number of children in classrooms with a Reading Corps tutor 601 1,472

Source: First 5 CCD database for July 1, 2014 – June 30, 2015; Early Literacy Foundations (ELF) Initiative, 2007-15.

* The SEEDS Plus program was offered from 2011-2013, and was designed for “graduates” of the early SEEDS of Early Literacy classes. This course was designed to promote and embed the ongoing use of SEEDS strategies, identify children who would receive tailored literacy-based interventions (using Response to Interventions (RtI) strategies), and increase the number of children on target with early reading predictors. Currently, SEEDS skills are incorporated into all SEEDS of Early Literacy trainings for SEEDS coaches and early childhood educators, without the use of RtI.

** In 2011-12, no formal SEEDS workshops were provided to FFN informal child care providers. However, approximately 45 FFN informal child care providers participated in a weekly “read aloud” group that modeled early literacy strategies. No personal information was collected for these 45 FFN informal child care providers. Therefore, these cumulative totals likely include duplicated clients.

Indicator: Number of early childhood educators who complete SEEDS training, and number of educators who are SEEDS coaches



The following figures show additional data about early childhood educators who have been trained

in the SEEDS of Early Literacy between 2007-2015.

Figure 33: Number of SEEDS-Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007-2015)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, 2007-2015.

Note: SEEDS-Trained Early Childhood Educators include SEEDS coaches and participants in all SEEDS classes offered since 2007. Family, Friend or Neighbor (FFN) informal child care providers and Santa Cruz Reading Corps Literacy Tutors are not included in these analyses.

Figure 34: Key Demographics of SEEDS-Trained Early Childhood Educators in Licensed Programs (2007-2015)

Primary Language

Educational Attainment

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Client and Assessment Data Entry Template, 2007-2015.


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=446; (Education) N=414.

27.1%

48.7%

21.7%

2.5%

English Only

Spanish Only

Bilingual English/Spanish

Other

8.7%

9.7%

20.3%

27.1%

6.3%

10.6%

8.5%

4.1%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

Educators in State and

Federally-Subsidized Classrooms

Educators in Licensed Family Child Care Homes

and Private/Non-Profit Centers

Total Number

(Unduplicated)

209 214 15

Educators in Public School

Transitional Kindergarten Classrooms

438



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 35: Number of Children Participating in Raising A Reader (2014-2015)

New Existing Total

Children 2,475 1,654 4,129


Preschool and Transitional Kindergarten 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.”

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 that 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 have used varying elements

of 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.

Indicator: Number of children participating in Raising A Reader

Indicator: Percentage of early education settings that provide high quality support for language and literacy



Across all components, classrooms showed improvements from the beginning of the semester to

the end.

Overall, in 2014-15 the percentage of classrooms that were rated as having High-Quality

Support increased from 20% to 93%.

The classroom component where the most change occurred was in “Language Environment,”

where the percentage of classrooms rated as having High-Quality Support increased from 0%

at the beginning of the semester to 93% by the end of the semester.

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

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).

For this analysis, several years of data have been aggregated16 in order to present a more robust

portrait of the extent to which SEEDS-trained early childhood educators in family child care settings

were providing high quality support for language and literacy in their preschool classrooms.

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 44%

to 89%.

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 all areas:

“Physical Environment for Learning” (93%), “Support for Learning” (87%), 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 40% to 56%.

16

Between 2008-2011, early childhood educators in family child care settings did not use the CHELLO, and consequently no CHELLO data were collected during those years. Therefore, this analysis represents the results for the years that the CHELLO has been utilized (2007-2008, and 2011-present).



State Pre-K and Transitional Kindergarten (TK) Classrooms

The Santa Cruz Reading Corps (SCRC) places one AmeriCorps volunteer (called a Literacy Tutor) in

each State Preschool and TK classroom at Live Oak School District, and in each State Preschool

classroom and one TK classroom at Pajaro Valley Unified School District. The 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. In 2014-15, 14 Literacy Tutors were trained and placed in 24

different classrooms17, serving 601 children.

Santa Cruz Reading Corps’ Literacy Tutors are trained in the use of Response to Interventions (RtI)

strategies as a way to provide children with tailored literacy support. 18 Literacy Tutors assess

children’s pre-literacy skills in five areas: Picture Naming, Rhyming, and Alliteration (as measured by

the Individual Growth and Development Indicators (IGDIs)), and Letter Naming and Letter Sounds (as

measured by the Formative Assessment System for Teachers (FAST)). These assessments help the

Tutors recognize children who need tailored literacy support and respond in ways that help the

children experience early school success.

There are three important factors to note regarding these analyses of children’s pre-literacy skills:

Focus on English skills. Beginning in 2012-13, there was an emphasis in all “SEEDS”

classrooms on developing and improving children’s vocabulary skills in English. As the

majority of preschool students were dual language learners, many children were initially

assessed in both English and Spanish. Once these children demonstrated proficiency in their

scores on the English-language assessments, however, they did not continue taking the

Spanish-language assessments. Therefore, the analyses in this report illustrate the amount of

improvement that children made in their English pre-literacy skills.

Focus on children about to enter kindergarten. Only children ages 4 and 5 were included in

these IGDIs analyses, in order to focus on children who were at a similar developmental age

just before entering kindergarten. Additionally, the companion assessment given along with

17

Many classrooms offer services to more than one cohort of children a day. In 2014-15, across 16 sites, there were 24 different cohorts of children.

18 Children who received tailored literacy-based intervention strategies received more frequent monitoring. In addition to the three

benchmark IGDIs assessments, these children took two additional assessments between the 1st and 2

nd benchmark assessments (called

Progress Monitoring 1 and 2), and then two more assessments between the 2nd

and 3rd

benchmark assessments (called Progress Monitoring 3 and 4). If a child demonstrated sufficient improvement by the 2

nd 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 Monitoring 3 and 4). Consequently,

every child who received an intervention was monitored at least two additional times with the Progress Monitoring assessments.

Indicator: Percentage of children who demonstrate research-based predictors of later reading success



the IGDIs assessment (the Formative Assessment System for Teachers) is not designed for

children younger than 4, which provided a framework for focusing on children ages 4 and 5.19

Cumulative results. Several years of data have been aggregated in order to present a more

robust portrait of the extent to which children were benefiting from the SEEDS of Early

Literacy curriculum and individualized support.

Results

Children in classrooms incorporating the SEEDS of Early Literacy curriculum are demonstrating

improvements in their pre-literacy skills. When looking at the percentage of children ages 4+ who

were meeting targets for later reading success in English (scoring “At” or “Above” target level),

results showed that:

On average, by the end of the year more children were “At/Above” target level in all five pre-

literacy skill areas—in English—no matter what their primary language was.

o Letter Naming and Letter Sounds were the skill areas that had the highest percentage of

children who were “At/Above” target level by the end of the school year.

o An analysis of average scores on the Fall, Winter, and Spring benchmarks demonstrated

how much progress children made over the course of the school year. When assessed in

English, Spanish-speaking children on average started with lower scores than English-

speaking children, but by their last assessment they had increased their scores by a higher

amount than English-speaking children in Picture Naming and Rhyming, and nearly

equaled the English-speaking children’s increase in scores in Alliteration.

Figure 36: Reading Corps Classrooms: Children Ages 4+ Who Are At/Above Targets for Later Reading Success, in English (2012-2015)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Reading Corps Individual Growth and Development Indicators (IGDIs)

and Formative Assessment System for Teachers (FAST) Assessment Tools, 2012-2015. Note: Children who completed at least (any) two benchmark assessments within a pre-literacy skill area were included in the analysis of that skill.

Only children ages 4 and 5 were included in this analysis. N: English N= Oct.: Picture Naming (325), Rhyming (281), Alliteration (264), Letter Naming (318), Letter Sounds (308). N= Feb.: Picture Naming (355),

Rhyming (330), Alliteration (317), Letter Naming (339), Letter Sounds (323). N= May: Picture Naming (336), Rhyming (316), Alliteration (295), Letter Naming (330), Letter Sounds (311). Spanish N= Oct.: Picture Naming (596), Rhyming (529), Alliteration (539), Letter Naming (592), Letter Sounds (565). N= Feb.: Picture Naming (679), Rhyming (635), Alliteration (612), Letter Naming (647), Letter Sounds (611). N= May: Picture Naming (657), Rhyming (618), Alliteration (605), Letter Naming (646), Letter Sounds (608).

19

This focus on children 4 and 5 began in 2013-14, and IGIDs and FAST data for all previous years have been adjusted accordingly.

17.8%11.7% 11.4%

21.4%13.3%

2.7% 3.0% 4.6% 7.9% 5.8%

33.5%26.4% 20.8%

42.8%32.5%

8.1% 13.2%16.2%

25.0% 24.4%

49.7%42.1%

46.8%

60.6%54.3%

19.2%

28.8% 31.6%42.4% 44.4%

0%

20%

40%

60%

80%

100%

PictureNaming

Rhyming Alliteration LetterNaming

LetterSounds

PictureNaming


LetterSounds

1st Benchmark (Oct.) 2nd Benchmark (Feb.) 3rd Benchmark (May)

Primarily Spanish-Speaking Children

Primarily English-Speaking Children



Figure 37: Children in Reading Corps Classrooms: Average Scores and Average Growth in Scores (Fall to Spring) – in English

Picture Naming Letter Naming

Rhyming Letter Sounds

Alliteration

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Reading Corps Individual Growth and Development Indicators (IGDIs) and Formative Assessment System for Teachers (FAST) Assessment Tools, 2012-2015.

Note: Children who completed at least (any) two benchmark assessments within a pre-literacy skill area were included in the analysis of that skill. Only children ages 4 and 5 were included in this analysis. Average scores and average growths have been rounded.

N: English N= Oct.: Picture Naming (325), Rhyming (281), Alliteration (264), Letter Naming (318), Letter Sounds (308). N= Feb.: Picture Naming (355), Rhyming (330), Alliteration (317), Letter Naming (339), Letter Sounds (323). N= May: Picture Naming (336), Rhyming (316), Alliteration (295), Letter Naming (330), Letter Sounds (311). Spanish N= Oct.: Picture Naming (596), Rhyming (529), Alliteration (539), Letter Naming (592), Letter Sounds (565). N= Feb.: Picture Naming (679), Rhyming (635), Alliteration (612), Letter Naming (647), Letter Sounds (611). N= May: Picture Naming (657), Rhyming (618), Alliteration (605), Letter Naming (646), Letter Sounds (608).

0

2 Primarily English-Speaking Children


6.89.1

17.821.9

24.6

8.8

13.717.9

0

5

10

15

20

25

30

Oct. Feb. May AverageGrowth

11.49.78.0

14.3

19.4

3.9

8.8

13.6

0

5

10

15

20

25


4.65.15.0

7.2

9.6

2.8

5.4

7.9

0

2

4

6

8

10

12


7.66.4

2.8

6.7

10.4

1.7

4.7

8.1

0

2

4

6

8

10

12


3.9 3.43.04.5

6.9

1.8

3.75.2

0

2

4

6

8




Children who received tailored interventions are nearly catching up with their peers. 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 needed to be done to help Spanish-speaking children increase their English

vocabulary (Picture Naming).

To this end, the “Repeated Read Aloud” (RRA) intervention was introduced in 2014-15 as a way to

increase vocabulary and fluency in English. Literacy Tutors used the IGDIs and FAST assessments to

help them identify five children who were most challenged in picture naming (vocabulary), and

provided each of these children with this tailored intervention.

In these 2014-15 analyses of IGDIs and FAST assessments in English, the results are shown for

children who did not require interventions, and for children who received the RRA tailored

interventions. The first set of analyses show the percentage of children at each level of proficiency

at each of the three benchmarks (below target, near target, at/above target), and the second

analysis shows the average scores at each of the three benchmarks, and the average growth from

Fall to Spring.

Overall results show that children who received tailored interventions showed remarkable

progress towards reaching greater proficiency in all pre-literacy skill areas, in English.

As would be expected, almost all children who were chosen to receive tailored interventions

had scored “Below” target at the beginning of the school year on the English-language

assessments. However, by the end of the school year, a majority of these children had moved

up into higher levels of proficiency (“Near,” or “At/Above” target).


Spanish-speaking children who had received tailored interventions.

o Not only did these Spanish-speaking children improve their skill levels, but the

percentages who were “Near,” or “At/Above” target by the end of the school year came

quite close to the percentages of their peers who had not required these tailored

interventions. This was particularly true in the areas of Alliteration, Letter Naming, and

Letter Sounds.

o An analysis of average scores on the Fall, Winter, and Spring benchmarks showed that

when assessed in English, Spanish-speaking children who were selected to receive tailored

interventions on average started with lower scores than Spanish-speaking children who

did not require tailored interventions. But by their last assessment they had increased

their scores by a higher amount in Picture Naming and Rhyming.

This last result is especially encouraging, as it suggests that these tailored interventions are

greatly helping dual-language learners who are the most challenged with their English

vocabulary skills. These children are getting the tailored help they need to increase their

vocabulary and bring them up to a level where they can more fully benefit from the SEEDS of

Early Literacy classroom curriculum with the rest of their peers.



Figure 38: Impact of Tailored Interventions on Children’s Proficiency in Key Pre-Literacy Skills (2014-2015) – in English

Primarily Spanish-Speaking Children Not Requiring Tailored Interventions

Primarily Spanish-Speaking Children Who Received Tailored Interventions


and Formative Assessment System for Teachers (FAST) Assessment Tools, 2014-2015.

Note: Children who completed at least (any) two benchmark assessments within a pre-literacy skill area were included in the analysis of that skill. Only children ages 4 and 5 were included in this analysis.

N: “Children with No Intervention”—(Picture Naming) Oct =89, Feb=104, May=99; (Rhyming) Oct =76, Feb=96, May=90; (Alliteration) Oct =73, Feb=89, May=89; (Letter Naming) Oct =86, Feb=102, May=100; (Letter Sounds) Oct =74, Feb=93, May=88; Children with Interventions—(Picture Naming) Oct =71, Feb=84, May=77; (Rhyming) Oct =57, Feb=76, May=72; (Alliteration) Oct =65, Feb=78, May=73; (Letter Naming) Oct =69, Feb=83, May=80; (Letter Sounds) Oct =70, Feb=82, May=74.

59.6%39.4%

22.2%

69.7%58.3%

36.7%

76.7%64.0%

48.3%

69.8%

51.0%32.0%

79.7%

61.3%

37.5%

33.7%51.0%

60.6%

22.4%26.0%

33.3%

17.8%27.0%

29.2%

16.3%

17.6%

18.0%

9.5%

12.9%

11.4%

6.7% 9.6% 17.2%7.9%

15.6%30.0%

5.5% 9.0%22.5%

14.0%

31.4%

50.0%

10.8%25.8%

51.1%

0%

20%

40%

60%

80%

100%

Oct Feb May Oct Feb May Oct Feb May Oct Feb May Oct Feb May

Below Target Near Target At/Above Target

94.4%72.6%

36.4%

89.5%71.1%

50.0%

80.0%71.8%

56.2%

78.3%

57.8%

33.8%

94.3%

67.1%

41.9%

5.6%26.2%

50.6%

10.5%23.7%

33.3%

12.3% 21.8%

20.5%

7.2%

20.5%

22.5%

2.9%

13.4%

13.5%

0.0% 1.2%13.0%

0.0%5.3%

16.7%

7.7% 6.4%23.3%

14.5%21.7%

43.8%

2.9%

19.5%

44.6%

0%

20%

40%

60%

80%

100%



Picture Naming Rhyming Alliteration Letter Naming Letter Sounds




Figure 39: Impact of Tailored Interventions: Average Scores and Average Growth in Scores (Fall to Spring)

Primarily Spanish-Speaking Children – in English



Alliteration




Did Not Require Tailored Interventions

Received Tailored Interventions

5.8

9.7

14.016.2

19.8

7.2

11.9

16.9

0

5

10

15

20

25


10.2 10.1

6.2

10.9

16.4

5.1

10.4

15.2

0

5

10

15

20


3.44.14.7

6.1

8.1

2.2

4.0

6.3

0

2

4

6

8

10


7.2 7.3

2.3

5.2

9.6

1.0

4.2

8.3

0

2

4

6

8

10

12


2.4 1.92.1

3.0

4.6

2.02.3

3.9

0

1

2

3

4

5




Summer Pre-K Academy

Pre-school children who participated in the 4-week Migrant Education Summer Pre-K Academy were

assessed in their ability to recognize letter sounds in their primary language. Of the children who

participated in at least 14 sessions, 86% increased their letter sound recognition by at least five

letter sounds, and on average, they learned to recognize 12 new letter sounds by the time they left

the program.

Figure 40: Changes in Students’ Letter Sound Recognition Skills After Participation in the Migrant Education Summer Pre-K Academy (2015)

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, 2014.

N=55

.

85.5%

0%

20%

40%

60%

80%

100%

6.4

18.3

0

5

10

15

20

Pre Post

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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 2014-15, approximately 15% of children received services from multiple First 5 partners.

This may be lower than previous years due to the absence of the Child Snapshot program,

which often served over 700 children who were likely to be involved in other First 5 services.

Not surprisingly, the agency with the highest child enrollment—Raising A Reader (with 4,129

children)—had the highest number of children who also participated in other programs,

including Early Literacy Foundations Reading Corps classrooms (530 children shared), Healthy

Kids Initiative (163 children shared), Families Together (125 children shared), and Triple P

(120 children shared).

Figure 41: Percentage of Children Receiving Services from Multiple First 5 Partners

Source: First 5 CCD database for July 1, 2006 - June 30, 2015.

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; (2013-14) N=6,840, (2014-15) N=6,328.

12.8%

20.3%

13.0%14.6%

17.8% 18.8% 17.9%21.9%

14.6%

0%

10%

20%

30%

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15

Indicator: Number of families who receive services from multiple First 5 grantees

SERVICE INTEGRATION & COMMUNITY STRENGTHENING

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT SERVICE INTEGRATION AND COMMUNITY STRENGTHENING


Health, social services, and early education providers in the County participated in trainings and

helped distribute materials: 13 service providers participated in First 5’s “Achieving Excellence in

Customer Service” trainings; 763 Kits for New Parents were shipped to clinics, hospitals, service

providers, and events throughout the County, for distribution to individuals.

First 5 Fiscal Status and Sustainability

The balances on this statement were as of June 30, 2015. The Statement of Net Assets indicates that

net assets decreased by $1,414,270 from July 1, 2014 to June 30, 2015. This decrease in net assets is

part of the Commission’s planned use of its sustainability fund for program investments as set forth

in the Strategic Plan. For the year ended June 30, 2015, the ending fund balance was $1,778,790, a

decrease of $1,414,270 from the prior year.

Figure 42: Statement of Activities, Fiscal Year 2014-2015

Revenue Prop 10 Allocation $ 2,095,274

Interest on Prop 10 Funds $ 11,948

Packard Foundation Grant $ 200,000

Mental Health Services Act $ 218,559

Race To The Top $ 320,480

First 5 California Child Signature Program #2 $ 52,500

Other $ 78,933

Total Revenue $ 2,977,694

Expenses Program

Children Learning & Ready for School $ 1,546,914

Healthy Children $ 635,820

Strong Families $ 1,330,717

Service Integration $ 63,458

Program Support $ 333,287

Evaluation $ 157,961

Administration $ 319,964

Depreciation $ 3,843

Total Expenditures $ 4,391,964

Excess of expenditures over revenues $ (1,414,270)

Fund balance - beginning of year $ 3,193,060

Fund balance - end of year $ 1,778,790

Source: First 5 Santa Cruz County audited financial statements (2014-2015).

Indicator: Distribution of information to community service providers

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 2014-2015, First 5 funding was leveraged by these partners to bring in the following

additional revenue.

Figure 43: Amount of Funding Leveraged by Partners, by Type (2014-2015)

SOURCE OF LEVERAGED FUNDING LEVERAGED FUNDING AMOUNT

Public agency - Local $734,620

Public agency - State $142,168

Business or Individual $234,387

Medi-Cal Administrative Activities (MAA) $59,263

Public agency - Federal $236,263

Early Periodic Screening, Diagnosis, and Treatment (EPSDT) $50,965

Private Foundation $130,989

Educational Institution $59,205

Total $1,647,860 Source: First 5 Santa Cruz County and First 5 partner Annual Progress Reports, 2014-2015.

Figure 44: Total Amount of First 5 Funding and Leveraged Investments (2014-2015)

Source: First 5 Santa Cruz County and First 5 partner Annual Progress Reports, 2014-2015.

$1,647,860 $1,647,860$870,472

$870,472$3,521,492

$3,521,492$4,391,964

$6,039,824

$0

$2,500,000

$5,000,000

$7,500,000

$10,000,000

Total First 5 Funding Additional FundingLeveraged by Partners

First 5 and LeveragedFunding Combined

First 5: Prop 10 Funding

First 5: Other Funding Sources

Additional Funding Leverged byPartners

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 27,212 people have called, with a total of 40,899 needs and 46,101 referrals

provided.

The most common types of callers’ needs and resulting referrals were for assistance with

housing and utilities, health services, community resources, income assistance, and legal and

public safety services.

Figure 45: Number of 2-1-1 Callers, Needs, and Service Referrals

Source: United Way of Santa Cruz County, Call Report, 2011-2015.

5,157 5,797 7,347

4,5745,745

7,7564,703

7,136

8,0916,521

11,216

11,595

6,257

11,005

11,312

27,212

40,899

46,101

0

10,000

20,000

30,000

40,000

50,000

Number of Callers Number of Needs Number of Referrals

TOTAL

2014-15

2013-14

2012-13

2011-12

2010-11

Indicator: Access and utilization of the 2-1-1 program



Figure 46: Types of 2-1-1 Callers’ Needs (2011-2015)

Figure 47: Types of 2-1-1 Service Referrals (2011-2015)

Source: United Way of Santa Cruz County, Call Report, 2010/11 – 2014/15.

N: (Caller’s Needs)=40,899; (Types of Referrals)=46,101.

31.4%

13.2%

11.6%

11.4%

11.2%

10.9%

3.2%1.9% 5.2%

Housing/Utilities/Homeless Services

Health Care / Counseling / Addictions

Individual, Family and Community Support

Income Support/Tax Assistance

Legal, Consumer and Public Safety, Disaster Services

Food/Meals

Clothing/Personal/Household Needs

Transportation

Other

32.1%

24.2%

10.3%

9.5%

9.2%

5.1%

3.8%1.5% 4.3%

Individual, Family and Community Support

Housing/Utilities/Homeless Services

Income Support/Tax Assistance

Legal, Consumer and Public Safety, Disaster Services

Health Care / Counseling / Addictions

Employment Services

Food/Meals

Education

Other

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES


PART 2: PARTNER PROFILES

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT


PARTNER PROFILES

This section of the report provides a snapshot of each First 5 partner’s work Between July 1, 2014

and June 30, 2015.

At the beginning of the 2014-15 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 First 5’s

Apricot 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 2014-15. 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 2014-15.

Finally, it should be noted that these profiles only provide an overview of the innovative work that

each partner or initiative implements, and that more comprehensive detail about each partner’s

progress is provided in their annual report to First 5.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES HEALTHY CHILDREN - HEALTHY KIDS INITIATIVE


“As a CAA I have met many families who are in need of insurance for their children. However, one family’s story reminds me of the importance of what we do. I met a mother who had a 4-year-old who was diagnosed with asthma, but she could not afford to pay for private insurance. When she realized she could qualify for one of the County programs she was very grateful. After the child was granted the health insurance the mother called and said. “Now I can let my child run with no worry!”

Our work is far beyond helping people apply for health insurance; we provide families with information that allows a 4-year-old to run worry-free.”

- Certified Application Assistor, First 5 Santa Cruz County

Healthy Children

Healthy Kids Initiative

Health Care Outreach Coalition

Program Description

The Health Care Outreach Coalition (HCOC) provides assistance with applications and enrollment in

public health insurance to income-eligible families. In 2014-15, HCOC was folded into the Benefits

Coalition, coordinated by the County of Santa Cruz Human

Services Department. Through community outreach

workers called Certified Application Assistors (CAAs) 20,

children from families earning up to 300% of the Federal

Poverty Level receive assistance in applying for Medi-Cal,

Covered California, and the local Healthy Kids health

insurance plan.

Additionally, staff participate in community events and

respond to business and community agency requests for

presentations and additional information regarding

health insurance. Staff also assist in the management of

the One-e-App online application system, providing

training and technical assistance to all CAAs.

With the introduction of the Affordable Care Act (ACA), there

have been many changes to public health insurance programs available to children. CAAs have

received intensive training that allows them to provide families with the assistance and support

necessary to keep eligible children enrolled in public health insurance benefits, which helps ensure a

more successful enrollment and retention process in all programs.

Population Served

2014-2015

Children 1,908


20

In this report, the title “CAA” is used to refer to both Certified Application Assistors and also individuals who are certified as Certified Enrollment Counselors (CECs), which is a title is specific to counselors providing Covered California services.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT HEALTHY CHILDREN - HEALTHY KIDS INITIATIVE


Outcome Objective: First 5-funded CAAs will assist children in applying for public health insurance

2014-2015

Total number of children assisted with insurance applications by First 5-funded CAAs 1,926*

New applications 197

Renewal applications 539

Newborn applications 1,190

Source: First 5 Apricot database, Healthy Kids Program, 2014-2015.

* The number of children in this analysis may be slightly higher than the total number of unduplicated children served, since a child could be assisted with different types of applications within the same year (new, newborn, and renewals).

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 are offered 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 2014-15 show how successful this program has been in providing these services to Santa

Cruz County mothers and newborns.

Of all 3,107 births that occurred in Santa Cruz County hospitals in 2014-15, 87% of mothers

received a newborn visit while in the hospital, and 67% accepted a “Kit for New Parents.”

Of all 1,704 mothers with Medi-Cal births, 70% were assisted to complete a Medi-Cal

application for their new babies.

Of the mothers who were assisted with Medi-Cal applications for their newborns, 80%

identified a preferred primary care provider (PCP) or clinic for their child before discharge

from the hospital, and were helped by the CAAs to schedule the first appointment for the

newborn.21

21

In previous years, the Baby Gateway results included the percentage of applicants who were assigned a primary care provider (PCP) by a CAA before discharge from the hospital. The Central California Alliance for Health now calls the patients after discharge from the hospital to assign them a PCP, so the CAAs are no longer able to track these assignments. However, the data collection system allows

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES HEALTHY CHILDREN - HEALTHY KIDS INITIATIVE


Figure 48: Newborn Enrollment Project Statistics (2014-2015)

PROGRAM COMPONENT WATSONVILLE

COMMUNITY

HOSPITAL

DOMINICAN

HOSPITAL SUTTER MATERNITY

& SURGERY CENTER

OF SANTA CRUZ TOTAL

Total Number of All Births in Santa Cruz County hospitals

1,239 848 1,020 3,107

Total Number of Newborn Visits (regardless of insurance status) 1,109 817 780 2,706 87.1%

Number of Kits for New Parents Distributed 729 686 656 2,071 66.7%

Total Number of Medi-Cal Births 1,061 386 257 1,704

Number of Completed Newborn Medi-Cal Applications

592 377 221 1,190 69.8%

Number of Newborn Medi-Cal Applicants who have identified a Preferred Primary Care Provider or Clinic for their newborn, before discharge

1

408 348 196 952 80.0%

Source: (Births) Santa Cruz County Public Health, 2015. (Visits, Kits) First 5 Santa Cruz County, Baby Gateway records, 2015. (Application data) First 5 Apricot database, Healthy Kids Program, 2014-2015. 1 Before FY 2013-14, this reflected the number of applicants who were assigned a primary care provider (PCP) by a CAA before discharge from the hospital. As of FY 2013-14, the Central California Alliance for Health now calls the patients after discharge from the hospital to assign them a PCP, so the CAAs are no longer able to track these assignments. However, the data collection system allows CAAs to record the number of applicants who have identified a preferred PCP or clinic before discharge from the hospital, and these results are presented here.

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, particularly at Watsonville

Community Hospital.

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

comparing data for the year prior to the launch (2008) to the most current year (2014), the

number of ED visits for infants under age 1 has decreased 40%.

Baby Gateway was launched at Dominican Hospital in January 2011. Between the year prior

(2010) and the most current year (2014), ED visits for infants under age 1 has stayed

relatively level, with a slight decrease of 4%.

CAAs to record the number of applicants who have identified a preferred PCP or clinic before leaving the hospital, and these results are presented here.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT HEALTHY CHILDREN - HEALTHY KIDS INITIATIVE


Figure 49: Number of Emergency Department Visits (Infants Less Than One Year Old)

Source: State of California, Office of Statewide Health Planning and Development (OSHPD), Healthcare Information Division, Emergency Department Pivot Profiles and customized reports, 2015.

2,2092,102

2,315

1,926

1,600 1,5661,526

1,268

617 655 724629 587

522 542 603

0

400

800

1,200

1,600

2,000

2,400

2007 2008 2009 2010 2011 2012 2013 2014

WatsonvilleCommunity Hospital

Dominican Hospital

Baby Gateway Launched at

Dominican Hospital

Baby Gateway Launched

at Watsonville Community

Hospital

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES HEALTHY CHILDREN - STANFORD NEURODEVELOPMENTAL FOSTER CARE CLINIC


“One newborn was discharged from the NICU to her loving foster parents. Like many parents and foster parents they came to their first appointment at SNDFCC with the hope that at 6 months ‘Lily’s’ development and behavior were fine. They were surprised to find out from the results of the developmental and behavioral assessments that she had a gross motor delay. She was referred to occupational therapy and started receiving services within 2 weeks.

Over 30% of the children seen in our foster care program were identified with developmental delays from our comprehensive evaluations. We assist families in making referrals and removing any obstacles they may have in accessing the recommended follow-up services.”

- Stanford Neurodevelopmental Foster Care Clinic, Annual Progress Report

Stanford Neurodevelopmental Foster Care Clinic

Program Description

The Stanford Neurodevelopmental Foster Care Clinic (“SNDFCC”) is an innovative, coordinated approach

to address the neurodevelopmental needs of very vulnerable children age 0-5 in the foster care system.

Nationally, almost one in five children face developmental disabilities or disabling behavioral challenges

before age eighteen, but fewer than half of these children are identified before the age of five.22 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.23 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 in

2011 a coordinated and multidisciplinary

neurodevelopmental consultative care clinic called the

Dominican Interdisciplinary Child Development Program

(DICDP). DICDP was a collaboration between the Dominican

Pediatrics Program, Lucile 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.

The DICDP went through a dramatic transformation in 2014 with

the closure of the Dominican Pediatrics Program. Losing the lead partner required a significant system

change, and after considerable planning Stanford Children’s Health stepped up as the lead agency and

opened a pediatric clinic named the Stanford Neurodevelopmental Foster Care Clinic within its new

Stanford Children’s Health Specialty Services Clinic in Capitola, CA. Stanford Children’s Health now

manages the clinical records, registration, scheduling, electronic medical records, and employment of the

clinical psychologist and licensed clinical social worker, with funding support from Lucile Packard

Children’s Hospital Stanford.

As before, the SNDFCC has 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

22

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.

23 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 2014-2015 ANNUAL EVALUATION REPORT HEALTHY CHILDREN - STANFORD NEURODEVELOPMENTAL FOSTER CARE CLINIC


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 (over the age of one).

A Stanford clinical psychologist meets with the child, biological family, and foster family to

discuss developmental and behavioral history and milestones.

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 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

2014-2015

CUMULATIVE

TOTALS*

2011-2015

Children (ages 0-5) 74 (ages 0-5) 296(ages 6+) 19

Source: First 5 CCD database for July 1, 2014 – June 30, 2015. * 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. Therefore, these cumulative totals likely include duplicated clients.

Program Objective: Assess developmental and mental health needs of children

2014-2015

Between July 1, 2014 and June 30, 2015,

100 children in the dependency court system of Santa Cruz County age 0-5 will obtain comprehensive developmental and behavioral evaluations to identify early intervention, mental health, or educational needs.

Approximately 50 children age 0-5 will have follow-up consultations.

In their Annual Progress Report, this program reported that:

74 children received comprehensive developmental and behavioral assessments.

7 of these children returned for a 2nd visit to follow up on developmental and behavioral concerns.

All children one year and older received assessments with a children’s mental health counselor to determine whether they would benefit from ongoing counseling services.

Source: Stanford Neurodevelopmental Foster Care Clinic Annual Progress Report. 2014-15.



Program Objective: Implement system changes

2014-2015


Continue to implement processes that reduce the time before children receive their recommended interventions.


The interagency collaboration between County Mental Health counselors, social workers, public health nurses at Child Protective Services, and Leaps & Bounds counselors has been effective in removing previous obstacles to starting early intervention services within a month.

The vast majority (over 90%) of the children who were referred for early intervention or educational services were receiving them in a timely manner.

The one exception was a child in foster care whose referral to Early Head Start was delayed because of the mother’s delay in signing the referral forms.


Program Objective: Increase provider capacity

2014-2015


Provide developmental and behavioral educational workshops for mental health counseling professionals in Santa Cruz County.


A 2-hour workshop on feeding challenges of foster care children was provided. It was well attended by social workers and counselors from County Mental Health, Child Protective Services, Dominican Hospital, and the Parents Center.


Program Objective: Provide parenting support

2014-2015


3 Triple P workshops for biologic parents and foster parents of children served in the SNDFCC will be provided.


Approximately 50 parents and foster parents received individual Triple P consultation with a trained Triple P practitioner. Many parents and foster parents had previously received other Triple P services, and seemed eager to discuss specific parenting strategies for challenging child behaviors.

There was difficulty getting attendees for the three Triple P workshops that were offered. Different topics and times will be offered in the future in an attempt to attract participants.


PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT HEALTHY CHILDREN - STANFORD NEURODEVELOPMENTAL FOSTER CARE CLINIC


In the following results, data from the past four fiscal years (2011-2015) have been aggregated in

order to present a more robust profile of the children served.

Figure 50: Demographics of the Children (Ages 0-5) Participating in the SNDFCC (2011-2015)

Gender Primary Language

Race/Ethnicity Age

Source: Stanford Neurodevelopmental Foster Care Clinic, Data Template, 2011-2015. N: (Gender, Race/Ethnicity, Age)=296; (Language)=295.

Figure 51: Percentage of Children in SNDFCC (Ages 0-5) With These Diagnoses and Services, at Intake (2011-2015)

Source: Stanford Neurodevelopmental Foster Care Clinic, Data Template, 2011-2015. Note: Data for different diagnoses and services were not always collected every year. Therefore, the number of children analyzed for each diagnosis and service may vary. Only diagnoses and services with percentages higher than 4% for at least one age group are shown. N: Ages 0-2 (IEP, ADHD, Occupational Therapy, Developmental Disability Services)=175; (Delayed, Severely Delayed)=168; (COMH Counselor)=73; Ages 3-5 (IEP, ADHD, Occupational Therapy, Developmental Disability Services)=121; (Delayed, Severely Delayed)=120; (COMH Counselor)=32. * 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. ** COMH = County Office of Mental Health

Male46.6%

Female53.4%

English90.2%

Spanish9.8%

Latino / Hispanic,

54.1%

Caucasian / White, 39.5%

Other, 6.4% 13.9%

28.7%

16.6%

12.8%

13.5%

14.5%< 1 year old

1 year old

2 years old

3 years old

4 years old

5 years old

25.0%

1.8% 2.9%1.4%

4.6% 4.6%

36.7%

13.3%11.6%

6.3% 5.0%

0%

10%

20%

30%

40%

"Delayed"Developmental

Level*

"Severely Delayed"Developmental

Level*

At Risk for ADHD Has a COMHCounselor**

Has an IEP ReceivingOccupational Therapy

ReceivingDevelopmental

Disability Services

Ages 0-2 Ages 3-5



Figure 52: Percentage of Children in SNDFCC (Ages 0-5) Provided With These Referrals (2011-2015)

Source: Stanford Neurodevelopmental Foster Care Clinic, Data Template, 2011-2015.

Note: Data for different referrals were not always collected every year. Therefore, the number of children analyzed for each referral may vary. Only referrals with percentages higher than 4% for at least one age group are shown.

N: Ages 0-2 (School district, Developmental Disability Services, Triple P, Audiology, Occupational Therapy)=175; (Behavior Management, Leaps & Bounds counselor)=73; (Head Start/Early Head Start)=97. Ages 3-5 (School district, Developmental Disability Services, Triple P, Audiology, Occupational Therapy)=121; (Behavior Management, Leaps & Bounds counselor)=32; (Head Start/Early Head Start)=53

* The Leaps & Bounds program is designed to support the healthy development of children ages 0-5 whose parents are recovering from methamphetamine or other drug use and who are participating in the County’s Dependency Drug Court Program.

SNDFCC staff note that many of the children in this program exhibit behavioral challenges, and all of

the children over age one are working with county mental health therapists. Many parents and

foster parents have taken parenting classes but need more individual parenting strategies to assist

with parenting challenges, which they feel Triple P services will be able to provide. Long-term

follow-up continues to be an important part of the program, and several children will need follow-

up developmental and behavioral assessments prior to kindergarten to assess their school readiness

skills.

0.6%

8.6%

3.1% 3.4% 2.7%4.6%

6.8%4.0%

31.4%

6.6% 7.5% 6.6% 6.3%2.5% 2.5%

0%

10%

20%

30%

40%

School district(IEP/IFSP

development)

DevelopmentalDisability Services

Head Start/EarlyHead Start

OccupationalTherapy

BehaviorManagement

Triple P (Parentingskills)

Leaps & BoundsCounselor*

Audiology

Ages 0-2 Ages 3-5

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT STRONG FAMILIES – FAMILIES TOGETHER


“’Julia’ was socially isolated and depressed, stemming from living in a city she didn’t know, without community or family. Due to her strained relationship with her daughter’s father, Julia felt especially disconnected from her daughter. In addition, she was also engaged in a custody battle that caused extreme stress and anxiety, and at times re-triggered her own childhood traumas.

Through her sessions at Families Together, she learned anger management skills and mindfulness techniques. These helped her to continue parenting positively while she tackled challenges in court. By the end of her services, Julia felt more attached with her daughter. She also met with her primary care physician for support with depression and anxiety, and found support systems in Santa Cruz that have allowed her to heal and move forward in positive ways.

During her closing session, Julia stated, ‘If it wasn’t for Families Together, I would be an angry, mean mom who didn’t know how to parent or take care of my kids. This program made me better at everything I was doing wrong.’”

-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 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).

Families Together’s 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.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – FAMILIES TOGETHER


Population Served

2014-2015

Families Together Pathway* Subtotal All Pathways

(unduplicated) Participated in

Triple P**

Total All Pathways + Triple P

(unduplicated) Brief Intensive Pending

Parents/Guardians 40 79 5 124 81 154

Children 60 120 6 186 (ages 0-5) 85 (ages 6+) 86

(ages 0-5) 207


* 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.

** Families Together only reports to First 5 the clients who are primary caregivers and who have a child under 6 years old. Therefore, although all of the clients who participate in Triple P through Families Together are also enrolled in Families Together, some clients may be reported as only being a Triple P client in this report if they are a “secondary caregiver,” or if they are a primary caregiver with no child under age 6. Triple P is one of the only funded partners that reports the number of children ages 6+ who received services.

Outcome Objective: Families receive referrals, initial assessments, and assigned services

Program Objectives 2014-2015

Accept referrals for at least 280 families per year who will be referred from Family and Children’s Services to Families Together and 10 families that will be referred from the community. FCS families will receive priority and community referrals will be monitored and reviewed prior to FT services being assigned.

173 FCS referrals

14 community referrals

Provide outreach and engage at least 75% of families referred to Families Together in an initial meeting

72.7%

N=1101

At least 150 primary caregivers per year will participate in Families Together 124

Source: (Referral and engagement results) Families Together Annual Progress Report and Referral and Initial Engagement Form, 2015. (Primary caregiver numbers) First 5 CCD database for July 1, 2014 – June 30, 2015. 1 This referral number refers to participant referrals from Family and Children’s Services that were made during the fiscal year, and may differ from the Population Served numbers due to the following: If the same participant was referred more than once, each referral is tracked separately in these referral numbers; if the participant was referred in the prior fiscal year, that participant was not included in this referral number (even if the participant continued to receive services during the current fiscal year). In 2012-13, Families Together also began accepting referrals from a few partner agencies (“Community Referrals”). However, these Community Referrals are also not included in this referral number, as the data for this diagram are provided by Family and Children’s Services, which only tracks its own referrals in this manner.



Figure 53: Case Flow Diagram (2014-2015)

Cases Referred to Families Together (FT): 1731

Initial Phone Contact Not Yet Made

63

Initial Phone Contact Successful

110

Attempting to contact

12

No contact made:

(Unable to contact, or no need to contact as case was reopened in CWS)

Referral Closed

51

Contact made:

(Client declined, or Ineligible for services)

Referral Closed

30

Contacted and initial meeting scheduled

80

Contact ended:

(Did not show up to meeting, or met but declined to participate)

Referral Closed

0

Consented to participate in

Families Together 2

80

Source: Families Together Annual Progress Report and Referral and Initial Engagement Form, 2015. 1 This referral number refers to participant referrals from Family and Children’s Services that were made during the fiscal year, and may differ from the Population Served numbers due to the following: If the same participant was referred more than once, each referral is tracked separately in these referral numbers; if the participant was referred in the prior fiscal year, that participant was not included in this referral number (even if the participant continued to receive services during the current fiscal year). In 2012-13, Families Together also began accepting referrals from a few partner agencies (“Community Referrals”). However, these Community Referrals are also not included in this referral number, as the data for this diagram are provided by Family and Children’s Services, which only tracks its own referrals in this manner. 2 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 a combination of the program’s Annual Progress Report and 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 2014-2015

75% of primary caregivers who participate in Families Together will demonstrate decreased risk based on a final assessment

74.0%

N=96


Note: 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.



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 2014-15, 74% of parents were found to have lower levels of risk at reassessment than at

baseline. This level of improvement has stayed relatively constant over time.

Figure 54: 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.

As can be seen, 64% of families were assessed as being “high risk” or “very high risk” upon intake,

and this dropped to 13% by the second reassessment, indicating that the program is helping families

reduce their level of risk.

In January 2015, deeper analyses were conducted on the 2007-2014 risk data, to address the

question of whether the improved results by the 2nd reassessment might be due to changes in the

population at that point, rather than changes in actual risk level.24 Results demonstrated that there

is little evidence that there are significant differences between the population of clients who begin

the Families Together program and those who stay long enough to reach the 1st and 2nd

reassessments. The results show that clients who are at highest risk are not necessarily more likely

to drop out of the program than other clients, and if anything, it is the lower-risk clients who tend to

24

First 5 Santa Cruz County, The Impact of the Families Together Program on Families’ Levels of Risk: A Deeper Look, January 2015.

71.1%

60.6% 63.0%

76.5% 74.7%79.3%

72.9% 74.0%

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)

2013/14(N = 70)

2014/15(N = 96)



leave the program early (either completing the program within six months as designed, or dropping

out). Therefore, the results suggest that the improved levels of risk by the 1st and 2nd reassessments

are the result of the impact of the Families Together program, rather than the result of a changing

population of clients.

Figure 55: Change in Families’ Risk Levels During Participation in the Families Together Program (July 2007 – June 2015)


* 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 2014

At least 95% of families who participate in Families Together will not have a substantiated allegation of abuse at least 6 months after case closure.

93.9%

N=66

Source: Santa Cruz County Human Services Department and Children’s Research Center. Families Together: Substantiated Child Abuse Study, 2015.

Note: Data are from the 2014 calendar year, in order to allow at least a 6 month period after case closure.

Of the 66 families who received services from Families Together and had their cases closed in

the 2014 calendar year:

o 94% 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 20% 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,

31.7%37.3%35.8%

48.4% 49.3%48.2%

16.5%

9.1%16.0%

3.5% 4.3%

0%

10%

20%

30%

40%

50%

60%

70%

Baseline* (N=589) 1st Reassessment (N=461) 2nd Reassessment (N=209)

Low Risk

Moderate Risk

High Risk

Very High Risk



they may have gained skills and resources during their participation in Families Together that

prevent court-mandated involvement with child welfare.

Figure 56: Percentage of Families Together Participants Who Do Not Have a Substantiated Allegation of Maltreatment Within 6 Months After Case Closure


Note: Data are for each calendar year, in order to allow at least a 6 month period after case closure.

N: (2008)=61, (2009)=74, (2010)=82, (2011)=72, (2012)=78, (2013)=56, (2014)=66.

Figure 57: Child Welfare Issues Occurring After Exit from Families Together (2014)


Note: Data are from the 2014 calendar year, in order to allow at least a 6 month period after case closure.

N=66.

Outcome Objective: Children have health insurance and a medical home


98% of children ages 5 and under have health insurance by exit from the program. 99.1% N=106

98% of children ages 5 and under will have a medical home by exit from the program. 100% N=106

Source: First 5 Apricot database, Medical Home & Insurance Status at Closure report, 2014-2015.

95.1% 92.0% 96.3% 91.7% 94.9% 98.2% 93.9%

0%

20%

40%

60%

80%

100%

2008 2009 2010 2011 2012 2013 2014

19.7%

6.1%

0%

20%

40%

60%

80%

100%

Re-Referral to Child Welfare within six monthsafter exit from Families Together

Substantiated Allegation of ChildMaltreatment within six months after exit

from Families Together



Outcome Objective: Families will have access to parenting support services structured by the Triple P curriculum


Of families who engage in Families Together services, demonstrated by at least 8 face-to-face meetings, at least 70% will receive parenting support through the Triple P curriculum.

54.4% N=149


In the analyses of the following Triple P outcomes, all the assessment data since the

commencement of the Triple P program at Families Together have been aggregated (January 2010 –

June 2015) 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 received support for specific parenting challenges

Families Together clients who received brief, one-on-one Triple P services (Level 3) reported

increased confidence in parenting, less difficulty with their children’s behavior, and increased

enjoyment in their parent/child relationship. An increase in support from partners was also reported

by Families Together clients who participated in brief Triple P services, as well as clients who

participated in in-depth Triple P sessions (Levels 4 and 5).

Figure 58: Increases in Positive Parenting (Families Together: 2010-2015)

Source: Triple P data from the Parenting Experience Survey, Questions 3, 6, 1, and 2, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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. 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).

4.03.5 3.2 3.3

4.43.8 3.8 3.9

0

1

2

3

4

5

Confidence in ParentalResponsibilities** (N=22)

Support from Partner in theirRole As a Parent* (N=46)

Reduction in Difficulty of Child'sBehavior** (N=22)

Positivity of ParentingExperience** (N=20)

Pre PostExtreme

Not at all

Higher is “Better”



Parents increased their use of positive parenting styles

Families Together clients who completed Levels 4 and 5 of the Triple P program reported an

increase in their use of positive parenting styles.

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 through

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.

Figure 59: Parents’ Use of Positive Parenting Styles (Families Together: 2010-2015)

Source: Triple P data from the Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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 less positive 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 reduced levels of conflict over parenting

After completing the program, Families Together clients on average indicated that there were

significantly fewer parenting and relationship issues that were problems.

On average, All Parents and all analyzed sub-populations (except Males) tended to score above

the clinical cut-off at the beginning of the program, and ended the program out of a range of

concern.

Males tended to report fewer parenting issues that were a source of conflict, compared to

other sub-populations.

3.2 2.93.3 3.4

3.03.5 3.1

2.6 2.4 2.6 2.7 2.52.8

2.5

1

2

3

4

5

6

7

All Parents**(N=90)

Male**(N=15)

Female**(N=75)

Latino**(N=49)

Caucasian**(N=38)

Spanish**(N=32)

English**(N=57)

Pre PostLess positive

More positive

Lower is

“Better”






Figure 60: Number of Parenting Issues That Have Been a Source of Conflict Between

Parents (Families Together: 2010-2015)

Source: Triple P data from the Parent Problem Checklist: Problem subscale, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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 two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Parents have increased levels of emotional well-being

On average, All Parents and most sub-populations participating in Triple P at Families

Together significantly lowered their level of depression, anxiety, and stress.

The amount of change was much higher for parents with scores in the Clinical Range of

Concern at Pre-test. This was the only sub-population that began within the Severe range,

and ended out of a range of concern.

Levels of stress were particularly improved. An analysis of Effect Sizes showed that on

average, All Parents and all sub-populations experienced a moderate to large magnitude of

change in their levels of stress. These results indicate that observed differences were not

only statistically significant but also meaningful.

5.3

8.8

3.96.0 5.4 5.3 5.2 5.5

3.65.9

2.1 4.2 4.0 3.3 3.6 3.60

4

8

12

16

All Parents**(N=44)

Clinical Rangeat PreTest**

(N=22)

Male**(N=14)

Female**(N=30)

Latino**(N=21)

Caucasian**(N=22)

Spanish**(N=13)

English**(N=30)

Pre Post


Clinical Cut-Off:

>5

Lower is

“Better”




Figure 61: Level of Parental Depression, Anxiety, and Stress (Families Together: 2010-2015)

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 2015. 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 very 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).

10.4

22.9

11.2 10.3 10.9 10.0 11.5 9.95.8 8.3 1.5 6.6 6.1 5.7 5.7 5.9

0

7

14

21

28

35

42

All Parents*(N=92)

ClinicalRange at

PreTest**(N=28)

Male**(N=15)

Female*(N=77)

Latino*(N=51)

Caucasian*(N=38)

Spanish**(N=33)

English*(N=58)

Pre Post

7.5

17.1

8.7 7.3 8.2 7.1 9.1 6.74.0 4.3 0.8 4.6 3.8 4.6 3.8 4.20

7

14

21

28

35

42

All Parents*(N=92)

ClinicalRange at

PreTest**(N=30)

Male**(N=15)

Female*(N=77)

Latino*(N=51)

Caucasian(N=38)

Spanish**(N=33)

English(N=58)

Pre Post

15.4

27.3

14.4 15.6 14.216.6

15.5 15.5

9.111.7

5.29.8

7.811.0

8.6 9.5

0

7

14

21

28

35

42

AllParents**

(N=92)

ClinicalRange at

PreTest**(N=28)

Male**(N=15)

Female**(N=77)

Latino**(N=51)

Caucasian**(N=38)

Spanish**(N=33)

English**(N=58)

Pre Post


No distress

Clinical Cut-offs:

Very Severe >=28

Severe >= 21

Moderate >=14


No distress

Clinical Cut-offs:

Very Severe >=20

Severe >=15

Moderate >=10


No distress

Clinical Cut-offs:

Very Severe >=34

Severe >=26

Moderate >=19

Lower is

“Better”

Lower is

“Better”

Lower is

“Better”



Parents reported improved child behavior

Families Together clients who completed the Triple P Program also reported a statistically significant

decrease in the number of child behaviors that were perceived to be a problem. These results

represent a moderate to large magnitude of change.

Figure 62: Number of Child Behaviors Perceived to Be a Problem (Families Together: 2010-2015)

Source: Triple P data from the Eyberg Child Behavior Inventory, analyzed by Applied Survey Research, Jan. 2010 - June 2015.

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 two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

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 quality of service they and their child

received (6.61).

Figure 63: Parents’ Satisfaction with Various Aspects of the Triple P Program (Families Together: 2010-2015)

Source: Triple P data from the Parent Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015.

Note: All items were on a 7-point scale. Higher scores indicate greater satisfaction.

14.8

21.3

12.2 15.4 14.6 14.8 16.4 14.3

7.811.2

5.8 8.2 8.56.9

9.57.0

0

6

12

18

24

30

36

All Parents**(N=81)


(N=43)

Male**(N=14)

Female**(N=67)

Latino**(N=42)

Caucasian**(N=36)

Spanish**(N=27)

English**(N=53)

Pre Post

6.30

6.36

6.40

6.61

1 2 3 4 5 6 7

11. Has the program helped you to develop skills that can beapplied to other family members? (N=107)

7. Has the program helped you to deal more effectively withproblems that arise in your family? (N=111)

6. Has the program helped you to deal more effectively with yourchild's behavior? (N=111)

1. How would you rate the quality of the service you and your childreceived? (N=111)



Clinical Cut-off:

>=15

Lower is

“Better”

FIRST 5 SANTA CRUZ COUNTY 2014-2015 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 8-9

sessions in a group with other families (Level 4 Group).

Level 5: Enhanced, Pathways & Family Transitions Triple P offers additional support to help

parents deal with stress and improve communication with their partners or co-parents (Level

5 Enhanced), handle anger or other difficult emotions (Level 5 Pathways) and co-parent after

a divorce or separation (Level 5 Family Transitions).

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 2014-2015 ANNUAL EVALUATION REPORT STRONG FAMILIES – TRIPLE P


Snapshot of 2014-15 Triple P Implementation and Results in Santa Cruz County

Level 1: Universal – Social Marketing Campaign

Branding & Messaging: Continued to raise awareness of Triple P through earned media, paid advertisements, event

sponsorships, social media, and video PSAs

Web site: Received 313 online registrations for Triple P classes

Triple P Warmline/Email/Facebook: Received 103 requests for Triple P information and services

Parenting Pocket Guides: Distributed approximately 8,500 bilingual Triple P parenting 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 501 new fans

Positive Parenting Passport: Developed “passport” program to engage parents in Triple P and positive parenting

activities; Partnered with local businesses to sponsor prizes

Earned Media: Received free media coverage of Triple P classes and articles 157 times

Ads & Sponsorships: Promoted Triple P via bus ads, Highway 17 billboard, newspaper ads, and sponsorship of

Santa Cruz Warriors Kids' Dunk and Santa Cruz Children's Museum of Discovery Mobile Museum

Low Intensity

High Intensity

Level 2: Selected Individual & Seminar General information and tips for specific parenting concerns

314 parents participated in Seminars; 234 parents received 1-time consultations

17 accredited practitioners were available to provide Seminars

81 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.

746 parents participated in Workshops; 81 parents received brief support though individual or group

sessions

81 accredited practitioners were available to provide Level 3 brief parent consultations and

workshops

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

385 parents received Level 4 Individual & Group services

69 accredited practitioners were available to provide Level 4 in-depth parenting support

Parents reported high levels of satisfaction with these services

Level 5: Enhanced, Pathways & Family Transitions Additional support for families

Families reported significant improvements in parenting style, child behavior,

and levels of conflict between parents

38 parents received Level 5 services

28 accredited practitioners were available to provide Level 5 specialized services

EXTE

NT

OF

REA

CH

INTO

TH

E C

OM

MU

NIT

Y

Broad Reach

Limited, Targeted

Reach

INTE

NSI

TY O

F SE

RV

ICES



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 2014-15, First 5

continued to implement a robust social marketing campaign that included monthly parenting

articles published in Growing Up in Santa Cruz, Santa Cruz Parent, the Register-Pajaronian, Aptos-

Capitola-Soquel Life, 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 bilingual Parenting Pocket Guides for families with children

from birth to 12-years old, families with teens, and families with children with special needs; a

monthly e-newsletter; paid advertisements on radio stations, buses and the Highway 17 billboard;

free media coverage (“earned media”), sponsorships of local conferences and events; and

promotion of First 5 as a hub for information and assistance with accessing Triple P services. This

year First 5 also engaged parents in a local “Passport” program that offered prizes for participation

in various positive parenting activities.

Accessibility of information. Families are responding to Triple P messages in the media and

online. They are using First 5’s website to register for parenting classes and requesting

assistance with accessing Triple P services through the centralized “warmline,” Facebook, and

the Triple P email address.

Encouragement to participate. Since the beginning of the Triple P program, approximately

7,331 parents and 13,246 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: First 5, Triple P Master Client Data Collection Template, 2015 (analyzed by First 5 and Applied Survey Research).

THIS FUNDING CYCLE

2014-2015

CUMULATIVE TOTALS

2010-2015

Parents/Guardians 1,719 7,331

Children (all ages) 3,173 13,246



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 were able to apply the skills they learned to other family members.

Parents’ Satisfaction with Various Aspects of the Triple P Program (2010-2015)

Source: Triple P data from the Parent Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015.

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. Over the past several years, analyses have consistently shown that

brief services are an effective way of getting parents initially engaged in the program, and gives

them an opportunity to participate in further services. Parents who attend Seminars and

Workshops frequently request follow-up services, and of parents who participate in multiple

services, those who begin with one or two brief consultations for specific parenting concerns are

likely to return later for in-depth consultations and multi-session programs.

Continued use of 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.

Seminar/Workshop Satisfaction Survey (2010-2015)

Source: Triple P data from the Seminar/Workshop Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015.

In fact, results from the July 2015 phone survey show that 54% of respondents who had

participated in a Workshop and 45% of respondents who had participated in a Seminar have

continued to use Triple P parenting strategies daily or almost daily.

6.26

6.34

6.43

6.48

1 2 3 4 5 6 7

11. Has the program helped you to develop skills that can beapplied to other family members? (N=1,055)

7. Has the program helped you to deal more effectively withproblems that arise in your family? (N=1,075)

6. Has the program helped you to deal more effectively with yourchild's behavior? (N=1,075)

1. How would you rate the quality of the service you and yourchild received? (N=1,074)

4.72

4.55

1 2 3 4 5

I am likely to use some of the parenting strategies inthe tip sheet. (N=3,827)

The seminar/workshop answered a question orconcern I have had about parenting. (N=3,834)

Highest Satisfaction

Lowest 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 (2010-2015)

Source: Triple P data from the Parenting Experience Survey, Questions 3, 6, 1, and 2, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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. There are no clinical cut-offs for this assessment. This analysis only includes parents who participated in Level 3 Primary Care services. ** 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 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.

o 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.

o Further analysis showed that of all parents who began in a “Clinical Range of Concern,” the

majority were out of the range of concern by the end of the program.

3.4 3.4 3.23.7

4.2 4.0 3.9 4.1

0

1

2

3

4

5


Support from Partner in theirRole As a Parent** (N=158)



Pre PostExtreme

Not at all




Percentage of Parents Who Demonstrated Improvement in These Key Parenting Issues (2010-2015)

Source: Triple P assessment results (analyzed by Applied Survey Research), 2015. (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=742, Clinical=363; (Style) All=844, Clinical=186, (Depression) All=908, Clinical=235; (Anxiety) All=907, Clinical=304; (Stress) All=907, Clinical=242.

Percentage of Parents Who Moved Out of the “Clinical Range” in These Key Parenting Issues (2010-2015)

Source: Triple P assessment results (analyzed by Applied Survey Research), 2015. (Child behavior) ECBI, Problem subscale; (Laxness, Over-reactivity, Hostility) Parenting Scale; (Depression, Anxiety, Stress) DASS-21.

N: (Child behavior)=363; (Laxness) =329; (Over-reactivity) =292; (Hostility)=186; (Depression) =235; (Anxiety) =304; (Stress) =242.

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 growing number of parents have

completed Teen Triple P (targeting families with youth ages 13-16).

Parents in Teen Triple P report more serious parenting issues, and demonstrate greater improvement

o 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 levels of stress and anxiety.

o Although parents in both Core and Teen Triple P showed significant improvement in their

parenting issues, parents in Teen Triple P tended to demonstrate a greater amount of

improvement by the end of the program.

80.2% 77.4%

55.0% 52.7%62.7%

91.7%81.7% 85.5% 86.5% 90.1%

0%

25%

50%

75%

100%

Perception of child'sbehavior

Overall parenting style Depression Anxiety Stress

All Parents Clinical Range at Pre-test

71.1%64.1% 68.8%

78.5%62.6% 62.2%

77.3%

0%

25%

50%

75%

100%

Perception ofchild's behavior

Laxness Over-reactivity Hostility Depression Anxiety Stress




and Teen Triple P (families with children 13-16) (2010-2015)

Number of problems with their partners over parenting

Stress

Over-reactive parenting style

Anxiety

Source: Triple P data from the Parent Problem Checklist, the Depression, Anxiety, Stress Scale – Short Version (DASS-21), and Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 - June 2015. * 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). *** When there were separate Clinical Cut-offs for Males and Females, this has been taken into account in each analysis so that results could be reported overall. In these instances, the separate Cut-off levels for each gender that are shown in the charts are for illustration purposes only.

Parents in Teen Triple P report being less over-reactive with their teenagers after completing the program

o Parents of adolescents reported using less over-reactive parenting styles after

participating in the in Teen Triple P program, and on average all sub-populations showed

significant improvement in this area.

5.9 7.0

3.7 4.1

0

4

8

12

16

Core**(N=491)

Teen**(N=49)

Pre Post

13.4 15.7

9.010.9

0

7

14

21

28

35

42

Core*(N=795)

Teen*(N=66)

Pre Post

3.54.0

2.93.2

1

2

3

4

5

6

7

Core*(N=732)

Teen**(N=67)

Pre Post

7.9 8.45.1 5.10

7

14

21

28

35

42

Core*(N=795)

Teen*(N=66)

Pre Post

Less over-reactive

Lower is

“Better”

Clinical Cut-Off:*** Female >= 4.0 Male >= 3.9

More over-reactive

Lower is

“Better” Clinical Cut-Off:

>5




No distress

Lower is

“Better”

Clinical Cut-offs:

Very Severe >=34

Severe >=26

Moderate >=19


No distress

Lower is

“Better”

Clinical Cut-offs:

Very Severe >=20

Severe >=15

Moderate >=10



Parents Use of Over-reactive Parenting Styles with their Adolescents (2010-2015)

Source: Triple P data from the Teen Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 - June 2015. Note: The Teen Parenting Scale measures parenting styles in 2 scales, and overall. Scores for each scale are calculated by averaging the participants’ responses for each of the items. Higher scores indicate less positive parenting styles. ** 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 in Teen Triple P report decreased amount of conflict with teenagers

o On average, mothers reported significant decreases in the amount of conflict between

themselves and their teenagers. Effect size analyses showed that on average, mothers

experienced a moderate to large magnitude of change, indicating that these observed

differences were not only statistically significant but also meaningful.

o Fathers also reported lowered amounts of conflict with their teenagers. As the number of

fathers with this assessment grows these improvements will likely become statistically

significant.

o Both mothers and fathers tended to score 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.

o Teenagers also reported significantly lowered amounts of conflict with their mothers. There

were not yet enough data on teenagers’ amount of conflict with their fathers to analyze.

Amount of Conflict Between Parents and Their Teenagers (2010-2015)

Source: Triple P data from the Conflict Behavior Questionnaire, analyzed by Applied Survey Research, Jan. 2010 - June 2015.

Note: The Conflict Behavior Questionnaire (CBQ) was utilized by clients participating in the Teen variant of Levels 4 and 5 of the Triple P Program, and assesses general conflict between parents and their children. The CBQ was completed by both parents and adolescents, and discriminates between distressed and non-distressed families. Scores could range from 0 (non-distressed) to 20 (distressed), with higher score indicating a greater amount of conflict.

* Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05.


3.9 3.7 4.0 3.64.1

3.0 2.83.2 2.9 3.2

1

2

3

4

5

6

7

All Parents** (N=63) Latino** (N=37) Caucasian** (N=23) Spanish** (N=32) English** (N=31)

Pre Post

8.911.1

7.64.8

7.34.8

0

5

10

15

20

Mother's report of conflictwith teenager**

(N=45)

Father's report of conflictwith teenager

(N=10)

Teenager's report of conflictwith Mother*

(N=19)

Pre PostHigh Amount

of Conflict

Low Amount of Conflict

Lower is

“Better” Clinical Cut-off:

>8.2

Clinical Cut-off:

>9.2

Clinical Cut-off:

>8

More over-reactive

Less over-reactive

Lower is

“Better”



Parents of children with special needs are also among those experiencing more serious

parenting issues, and are also benefitting from Triple P. A small but growing number of parents

have completed Stepping Stones Triple P, a specialized program for families with children who

have special needs. Results are already showing significant progress.

o Parents in Stepping Stones 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 levels of stress and depression.

o Although parents in both Core and Stepping Stones Triple P showed significant

improvement in their parenting issues, parents in Stepping Stones Triple P tended to

demonstrate a greater degree of improvement by the end of the program.


and Stepping Stones Triple P (families with children who have special needs) (2010-2015)

Lax parenting style

Stress

Number of child behaviors perceived to be a problem

Depression

Source: Triple P data from the Parenting Scale, ECBI, and the Depression, Anxiety, Stress Scale – Short Version (DASS-21), analyzed by Applied Survey Research, Jan. 2010 - June 2015. * 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). *** When there were separate Clinical Cut-offs for Males and Females, this has been taken into account in each analysis so that results could be reported overall. In these instances, the separate Cut-off levels for each gender that are shown in the charts are for illustration purposes only.

3.2

4.0

2.6 2.6

1

2

3

4

5

6

7

Core**(N=733)


Pre Post

13.4 14.7

9.06.7

0

7

14

21

28

35

42

Core*(N=795)


Pre Post

14.3

19.4

7.411.0

0

6

12

18

24

30

36

Core**(N=645)


Pre Post

9.46.96.0

2.40

7

14

21

28

35

42

Core*(N=796)


Pre Post



Clinical Cut-off:

>=15

Lower is

“Better”

More lax

Less lax

Lower is

“Better”

Clinical Cut-Off:*** Female >= 3.6

Male >= 3.4

No distress

Lower is

“Better”

Clinical Cut-offs:

Very Severe >=34

Severe >=26

Moderate >=19

Lower is

“Better”


No distress


Clinical Cut-offs:

Very Severe >=28

Severe >= 21

Moderate >=14



Increased use of positive parenting styles. There were significant improvements in parenting

styles, indicating parents became less lax, less over-reactive, and less hostile through the course of

the Triple P program.

Parents’ Use of Positive Parenting Styles (2010-2015)

Source: Triple P data from the Parenting Scale, Overall scores, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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 less positive 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. 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 (2010-2015)

Source: Triple P data from the Parent Problem Checklist: Problem subscale, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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).

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 of

3.23.1

3.3 3.43.0

3.5

3.13.1

2.6 2.6 2.6 2.72.4

2.82.5 2.6

1

2

3

4

5

6

7


Male**(N=230)

Female**(N=580)

Latino**(N=433)

Caucasian**(N=307)

Spanish**(N=298)

English**(N=496)

Child WelfareInvolved**

(N=188)

Pre Post

6.0

8.9

5.6 6.2 6.0 5.9 6.1 6.0 5.23.7

5.33.4 3.9 3.4 4.0 3.4 4.0 3.5

0

4

8

12

16


ClinicalRange at

PreTest**(N=318)

Male**(N=194)

Female**(N=351)

Latino**(N=283)

Caucasian**(N=212)

Spanish**(N=190)

English**(N=345)

ChildWelfare

Involved*(N=111)

Pre Post

Less positive


Clinical Cut-Off:

>5

Lower is

“Better”


More positive

Lower is

“Better”



Concern at Pre-test. This was the only sub-population that began within the Severe range, and

ended out of a range of concern.

Level of Parental Depression, Anxiety, and Stress (2010-2015)

Depression

Anxiety

Stress


9.4

23.5

7.7 10.2 10.2 8.3 10.9 8.6 9.16.010.8

5.7 6.1 6.3 5.4 6.5 5.6 6.50

7

14

21

28

35

42

All Parents*(N=873)

ClinicalRange at

PreTest**(N=225)

Male*(N=259)

Female*(N=614)

Latino*(N=467)

Caucasian*(N=327)

Spanish*(N=312)

English*(N=544)

ChildWelfare

Involved*(N=236)

Pre Post

8.0

18.6

6.48.6

8.7 6.6 9.1 7.3 8.45.1 8.6 4.6 5.3 5.3 4.5

5.74.6

5.80

7

14

21

28

35

42

All Parents*(N=872)

ClinicalRange at

PreTest**(N=293)

Male*(N=259)

Female*(N=613)

Latino*(N=467)

Caucasian*(N=326)

Spanish*(N=312)

English*(N=543)

ChildWelfare

Involved*(N=235)

Pre Post

13.6

27.2

11.5 14.5 13.013.9

13.313.8 12.4

9.113.5

8.4 9.4 8.3 9.8 8.5 9.3 9.1

0

7

14

21

28

35

42

All Parents*(N=872)

ClinicalRange at

PreTest**(N=235)

Male*(N=259)

Female**(N=613)

Latino*(N=466)

Caucasian*(N=327)

Spanish*(N=311)

English*(N=544)

ChildWelfare

Involved*(N=236)

Pre Post


No distress

Clinical Cut-offs:

Very Severe >=28

Severe >= 21

Moderate >=14


No distress

Clinical Cut-offs:

Very Severe >=20

Severe >=15

Moderate >=10


No distress

Clinical Cut-offs:

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 Females, Latinos, and Spanish-speaking parents.

Number of Child Behaviors Perceived to Be a Problem (2010-2015)

Source: Triple P data from the Eyberg Child Behavior Inventory: Problem subscale, analyzed by Applied Survey Research, Jan. 2010 - June 2015.



Level 5: Enhanced, Pathways, and Family Transitions

Level 5 offers additional support for families where parenting issues are compounded by parental

stress and/or relationship difficulties (Level 5 Enhanced), there is risk for child maltreatment due to

parents’ anger management issues or negative beliefs about their children’s behaviors (Level 5

Pathways), or parents are divorced or separated (Level 5 Family Transitions).

There has been a growing level of participation in Level 5 Family Transitions, and the following

results demonstrate the significant improvement in these parents’ relationships, parenting skills,

and children’s behaviors. These results are particularly noteworthy considering the very small

number of parents available for these analyses.

14.4

21.8

12.215.3 15.5

13.116.3

13.1 9.67.4

10.6

6.4 7.7 7.77.2

8.56.6 5.8

0

6

12

18

24

30

36


ClinicalRange at

PreTest**(N=352)

Male**(N=200)

Female**(N=512)

Latino**(N=393)

Caucasian**(N=255)

Spanish**(N=278)

English**(N=421)

ChildWelfare

Involved**(N=158)

Pre PostAll behaviors were

a problem


Clinical Cut-off:

>=15

Lower is

“Better”



Reduced levels of conflict between parents. After participation in Level 5 Family Transitions,

results demonstrated significant improvement in the levels of conflict between divorced or

separated parents.

Level of Co-Parental Conflict Between Divorced or Separated Parents (2013-2015)

Source: Triple P data from the Acrimony Scale, analyzed by Applied Survey Research, Jan. 2010 - June 2015.

Note: The Acrimony Scale measures co-parental conflict between separated or divorced parents who are participating in Level 5 Family Transitions. Scores range from 1 (low conflict) to 4 (high conflict).

* Results marked with an asterisk had PRE/POST differences that were statistically significant at p<.05.

Reduced levels of conflict over parenting. For parents who completed Level 5 Family Transitions,

on average they indicated that by the end of the program there were significantly fewer parenting

and relationship issues that were problems. Parents tended to score above the clinical cut-off at the

beginning of the program, and ended the program out of a range of concern. An analysis of

Effect Sizes showed that on average, these parents experienced a moderate to large magnitude

of change, indicating that these observed differences were not only statistically significant but

also meaningful.

Number of Parenting Issues That Have Been a Source of Conflict Between Parents (2010-2015)


2.2 2.0

0

1

2

3

4

Parents participating in Level 5Family Transitions*

(N=24)

Pre Post

6.04.0

0

4

8

12

16

All Parents in Level 5Family Transitions**

(N=23)

Pre Post


Clinical Cut-Off:

>5

Lower is

“Better”


Low conflict

Lower is

“Better”

High conflict



Increased use of positive parenting styles. For parents who participated in Level 5 Family

Transitions, there were significant improvements in parenting styles, indicating parents became

less lax, less over-reactive, and less hostile through the course of this program.

Parents’ Use of Positive Parenting Styles (2010-2015)

Source: Triple P data from the Parenting Scale, Overall scores, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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 less positive 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 an asterisk had PRE/POST differences that were statistically significant at p<.05.

Improvements in child behavior. For parents in Level 5 Family Transitions, there was a significant

reduction in the number of child behaviors that were perceived to be a problem. An analysis of

Effect Sizes showed that on average, parents experienced a moderate to large magnitude of

change. These results indicate that these observed differences were not only statistically

significant but also meaningful.

Number of Child Behaviors Perceived to Be a Problem (2010-2015)

Source: Triple P data from the Eyberg Child Behavior Inventory: Problem subscale, analyzed by Applied Survey Research, Jan. 2010 - June 2015.



3.0 2.7

1

2

3

4

5

6

7

All Parents in Level 5Family Transitions*

(N=34)

Pre Post

13.0

8.00

6

12

18

24

30

36

All Parents in Level 5Family Transitions**

(N=30)

Pre Post



Clinical Cut-off:

>=15

Lower is

“Better”

Less positive

More positive

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 have

their client data included in this evaluation of Triple P.

Source: First 5, Triple P Master Client Data Collection Template, 2015 (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, but are only reported once in this calculation of the number of unique clients served. 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. Therefore, these numbers are more representative of the number of services provided, rather than the number of clients served. Since the number of children is dependent on the accuracy of the parents and providers, the total number of children reported here should be considered a close approximation.

*** These totals include clients who may have participated in more than one Triple P service.

This Funding Cycle

2014-2015

Cumulative Totals

2010-2015

Clients Participating in Individual or Group Sessions – Unduplicated*

Parents/Guardians 618 2,455

AGES

0 – 5 AGES

6 – 12 AGES

13 – 16 AGES

17+ AGES

0 – 5 AGES

6 – 12 AGES

13 – 16 AGES

17+

Children 351 307 98 29 785 1,405 1,148 357 164 3,074

Clients Participating in Seminars & Workshops – Includes duplicates**



Clients Participating in Individual or Group Sessions – Client numbers only; No client data included in this evaluation

Parents/Guardians 41 203

Children (all ages) 62 323

TOTAL*** TOTAL***





Special analysis: Estimated number of unique Seminar/Workshop clients

Currently, there is only a limited amount of identifying information collected from parents who

participate in Seminars and Workshops, so it is not possible to identify clients who have attended

these programs more than once. Consequently, the numbers in Seminars and Workshops that are

reported in the previous table include clients who may have attended multiple times and are

therefore more representative of the number of services provided, rather than the number of

unique clients served.

In 2014-15 a method was developed to approximate the unique number of Seminar and Workshop

participants, using Triple P agencies’ counts of “new” or “returning” attendees. Based on this

method, approximately:

50% of Seminar participants attended more than one Seminar, resulting in an estimated 157

unique parents in 2014-15

Approximately 29% of Workshop participants attended more than one Workshop, resulting

in an estimated 528 unique parents in 2014-15

The methodology for counting the unique number of Seminar and Workshop participants will

continue to be refined to the extent possible.

Triple P Participant Details

Figure 64: Demographics of Triple P Parents/Guardians (2010-2015)

Gender

Language Ethnicity

Source: First 5 CCD database for July 1, 2010 – June 30, 2014 & First 5, Triple P Master Client Data Collection Template, 2015 (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; bilingual Spanish/English clients were instructed in English and therefore included in this category.

N: (Gender)=2,433, (Language)=2,443, (Ethnicity)=2,020.

0%

20%

40%

60%

80%

100%

73.9%

26.1% Male

Female

0%

20%

40%

60%

80%

100%

48.0%

52.0%English

Spanish

0%

20%

40%

60%

80%

100%

6.6%

66.2%

27.1%White/Caucasian

Latino/Hispanic

Other



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 (51%) of

Index Children were between 0-5 years of age, 39% were between ages 6-12, and 9% were

ages 13-16.

Figure 65: Ages of Children Chosen as the “Index” Child (2010-2015)

Source: First 5, Triple P Master Client Data Collection Template, 2015 (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=1,513.

Program Participation The following chart shows the types of Triple services that have been provided to participants since

the commencement of the program.

Figure 66: Types of Services Provided (2010-2015)

Source: Triple P Master Client Data Collection Template, 2015. Notes: Percentages include the services of clients who may have participated in multiple services, and the services to clients who did not consent to have their assessment data included in this evaluation. N=7,959.

51.0%

38.5%

9.3%1.3%

Ages 0-5

Ages 6-12

Ages 13-16

Ages 17+

19.9%

12.0%

38.8%

4.7%

12.0%

11.6%1.0%

Level 2 Seminar

Level 2 Individual

Level 3 Workshop

Level 3 Individual/Brief Group

Level 4 Standard

Level 4 Group

Level 5 (all types)



Details of Program Participation

Program Outreach Parents are hearing about the Triple P program and specific services in a variety of ways.

The top four ways that parents heard about Triple P were: Referred by an agency (45%),

Court/CPS/Social Worker (13%), School/Preschool provider (12%), and Friend/Relative

(11%).

Figure 67: How Participants First Heard about Triple P (2010-2015)

Source: First 5, Triple P Master Client Data Collection Template, 2015 (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. *Not an option in 2010-11 N = 1,871 participants with 1,975 responses.

The percentage of clients who are hearing about Triple P through the Media and

Advertisements has been increasing (from 2% in 2011 to 11% in 2015), suggesting that

the social marketing campaign is having the intended impact.

Figure 68: Percentage of Participants Who First Heard about Triple P from Media and Advertisements

Source: First 5, Triple P Master Client Data Collection Template, 2015 (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 responses: (2010-11)=196, (2011-12)=357, (2012-13)=435, (2013-14)=465, (2014-15)=499.

44.6%

12.9%

12.3%

10.7%

7.3%

5.7%6.6%

Referred by an agency

Court / CPS / Social Worker*

School / Preschool provider

Friend or relative

Flyer/Brochure

Media / Advertisements

Other

2.0%3.9% 3.4%

4.5%

10.8%

0%

5%

10%

15%

20%

2010-11 2011-12 2012-13 2013-14 2014-15



Service Completion Rates

Many program levels of Triple P require participants to attend multiple sessions. An analysis of the

percentage of parents who have completed these programs demonstrates the high degree of

clients’ commitment. Parents are considered to have completed their program after they attended

all the required sessions and completed the post-assessments.

Since the start of Triple P, over 70% of clients in the Level 3 Individual/Brief Group program,

which runs for 3-4 sessions, completed their services. This is closely followed by those in

Level 4 Group (66%; 8-9 sessions). Just over half of the clients in Level 4 Standard completed

their services (52%; 10 sessions) and Level 5 Family Transitions (54%; 5 sessions).

Figure 69: Percentage of Parents Who Completed Their Multi-Session Triple P Services (2010-2015)

Source: First 5, Triple P Master Client Data Collection Template, (analyzed by First 5 and Applied Survey Research), 2015. Note: Only parents who had sufficient time to have completed their services were included in this analysis. Program levels with fewer than 10 clients have been omitted from this analysis. * This excludes Level 4 clients with unknown assignments to Standard or Group N: (Level 3)=322 (Level 4 Standard)=652, (Level 4 Group)=549, (Level 4 Unspecified)=257, (Level 5 Family Transitions)=48, (Overall)=1,839.

Barriers to Participating in Triple P

First 5 Santa Cruz County was interested in identifying and addressing any barriers to participating in

Triple P services, and a set of questions were included in a phone survey conducted in July 2015 (a

description of this survey is provided later in this report). Of the 124 Triple P participants surveyed, 6

ended services before completing the program, and 16 missed at least one class or session in a

series. These survey participants were asked why they stopped participating and what would have

made it easier to attend.

Reasons provided by six participants for not completing Triple P services included: medical

issues, scheduling conflicts, new employment, lack of time, co-parent dropped out, and

difficulty with the practitioner.

Of those who completed their services but did not attend all sessions, work, child care issues,

and illness were mentioned most frequently. Other reasons included being too busy, and

relocation.

While the majority of the reasons provided were not within the control of First 5 Santa Cruz County

or Triple P practitioners, the survey participants’ feedback will be taken into consideration as

practitioners schedule future classes and help clients troubleshoot potential barriers to participating

in Triple P services.

69.9%52.1%

66.3%54.2% 61.2%

0%

20%

40%

60%

80%

100%

Level 3Individual / Brief

Group(3-4 sessions)

Level 4Standard*

(10 sessions)

Level 4 Group*(8-9 sessions)

Level 5 FamilyTransitions(5 sessions)

Overall



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.

Key results include:

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 5.30 to

6.48, on the 7-point scale, indicating a high

level of satisfaction with various aspects of the

program experience.

o On average, parents felt the highest satisfaction with the quality of the service they and

their child received (6.48). Parents reported that the program helped “somewhat” with

their relationship with their partner (5.30), which was the lowest rating given a question

on this survey. Although still a very high rating, this has consistently been the most

difficult issue over the years.

A further analysis of Satisfaction Surveys showed that clients’ satisfaction with their partner

was significantly more likely to be improved by the end of the Triple P program if they had

attended with another adult (who was usually this partner).

Figure 70: Percentage of Parents Whose Satisfaction with Their Partner Improved, With and Without Participation with Another Adult (2010-2015)

Source: First 5, Triple P Master Client Data Collection Template, analyzed by Applied Survey Research, Jan. 2010 - June 2015.

Notes: Chi-Square results were significant: Χ2(1, N = 1,391) = 20.2, p = .000. 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.

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 5 indicating highest

satisfaction), and 1 open-ended question. On average, parents in both services reported that

they would continue to use the tip sheets, that they were very satisfied with the services

they received, and that the program answered their question or concern.

38.1%50.2%

0%

25%

50%

75%

100%

Participated alone Participated with another adult

What Parents Are Saying

“I feel like the Triple P program has ideal solutions to everyday family problems. It's pretty much “right on” with the difficulties our family has.”

“I feel as though I've grown up even more as a father and have strengthened my bond with my son.”

“This program helped me not only in my relationship with my child, but helped me to improve myself and my self-esteem.”

“I thank Triple P for the skills I will cherish. I will have a second chance at having a nuclear family.”

- Triple P Client Satisfaction Surveys



Figure 71: Parents’ Satisfaction with the Triple P Program (2010-2015)

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 2015. 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 2015. Note: All items were on a 5-point scale. Higher scores indicate greater satisfaction.

6.07

5.99

6.26

6.40

6.32

5.30

6.34

6.43

6.05

6.02

5.83

6.33

6.48

1 2 3 4 5 6 7

13. How would you describe your feelings at this point about yourchild's progress? (N=1,045)

12. In your opinion, how is your child's behavior at this point?(N=1,053)

11. Has the program helped you to develop skills that can be appliedto other family members? (N=1,055)

10. If you were to seek help again, would you come back to thisorganization? (N=1,053)

9. In an overall sense, how satisfied are you with the program youand your child received? (N=1,051)

8. Do you think your relationship with your partner has beenimproved by the program? (N=917)

7. Has the program helped you to deal more effectively withproblems that arise in your family? (N=1,075)

6. Has the program helped you to deal more effectively with yourchild's behavior? (N=1,075)

5. How satisfied were you with the amount of help you and your childreceived? (N=1,065)

4. To what extent has the program met your needs? (N=1,073)

3. To what extent has the program met your child's needs? (N=1,066)

2. Did you receive the type of help you wanted from the program?(N=1,072)

1. How would you rate the quality of the service you and your childreceived? (N=1,074)

4.71

4.71

4.58

1 2 3 4 5

3. Overall I was satisfied with the workshop.(N=2,490)

2. I am likely to use some of the parentingstrategies in the tip sheet. (N=2,483)

1. The workshop answered a question or concernI have had about parenting. (N=2,491)


Lowest Satisfaction


Lowest Satisfaction



Level 2 Seminars

Source: Triple P data from the Seminar Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015.


Continued Use and Effectiveness of Triple P: A Follow-up Phone Survey

Over the last five years, Triple P has grown in response to the parenting support needs of residents

in Santa Cruz County. Triple P provides families in the county with a “tool kit” of proven strategies

for strengthening relationships with their children, promoting children’s development, and

preventing or managing common parenting challenges.

As part of its process of continuous quality improvement, First 5 Santa Cruz County

commissioned a phone survey of Triple P participants—conducted in July 2015—to better

understand the efficacy of Triple P among local families, how participants are using Triple

P strategies, how services may be improved, as well as how Triple P can reach more

families in the county who may benefit from services.25

Results

Participant details

o 124 parents/caregivers completed the phone survey (80% female and 20% male).

o Demographic data were collected for 70 participants.26 Of these:

57% were Latino, 34% were Caucasian, and 9% were another race/ethnicity.

Participants ranged in age from 23 to 65, with an average age of 37.

o 16% of participants had been court-mandated to attend Triple P.

o On average, parents/caregivers had last participated in Triple P services 10 months prior

to the interview.

Pathways to Triple P

o 80% of survey participants came to know about Triple P through a person or agency

referral. Of these, the majority were routed to Triple P via preschool or other school staff,

counselors or therapists, or family support staff.

o 10% of participants first heard about Triple P through a flyer or brochure.

o 5% of participants found Triple P from an advertisement.

25

The full report is available from First 5: Applied Survey Research, Triple P Santa Cruz County: Participant Pathways and Perspectives, 2015. 26

Demographic data were only available for participants who had attended Level 3 Individual/Brief Group, Level 4 Standard/Group, or Level 5 services, as these data were collected via the paperwork completed at the time of services.

4.68

4.75

4.50

1 2 3 4 5

3. Overall I was satisfied with the seminar(N=1,343)

2. I am likely to use some of the parentingstrategies in the tip sheet (N=1,344)

1. The seminar answered a question or concernI have had about parenting (N=1,343)


Lowest Satisfaction



How participants benefitted from Triple P

On average, survey participants had last participated in Triple P services 10

months prior to the interview. Of these parents/guardians:

o 77% reported improvement in their families as a result of Triple P.

o 95% reported they continue to use strategies learned from Triple P.

o When asked how frequently they used the skills they’d learned, a high

percentage of participants from all levels of Triple P reported that they

used them “Every day” or “Almost every day.” The highest percentages of participants

who reported daily or almost-daily use of strategies had participated in in-depth Individual

services (63%), in-depth Group services (56%), Workshops (54%), and Seminars (45%).

Frequency of Continued Strategy Use, by Type of Triple P Service Received


o The most helpful skills and strategies mentioned by survey participants were in the areas

of communication skills, assertive discipline, emotion regulation, and creating structure.

Most Helpful Strategies and Skills Learned


N-124.

3%10% 7% 5% 4% 6% 6%

9%5% 10% 16%

2% 3% 6%

44%31%

50%53%

30%35%

44%

24%

27%

7%

11%

24%

32%17%

21% 27% 27%16%

39%24% 28%

0%

20%

40%

60%

80%

100%

Level 2Seminar(N=35)

Level 3Workshop

(N=63)

Level 3(Brief)

Individual(N=31)

Level 3(Brief)Group(N=19)

Level 4(In-depth)Individual

(N=46)

Level 4(In-depth)

Group(N=34)

Level 5(Additional

support)(N=18)

Every day

Almost every day

A few times a week

Less than once a week

Never

2

3

5

7

11

13

20

22

25

38

Other

Co-parenting

Expectations

Self-care

Family cohesiveness

Listening skills

Structure & routines

Emotion regulation

Assertive discipline

Communication skills

Number of times mentioned by survey participants

95% of survey

participants reported

they continue to use

strategies learned

from Triple P



Satisfaction with services

o 82% of survey participants were “very satisfied” with the quality of Triple P instruction.

o 78% of survey participants were “very satisfied” with Triple P services.

Involvement in Triple P

o 98% of survey participants would recommend Triple P to family and friends.

o 81% of survey participants said that they were likely to participate in

another Triple P service.

o 59% of survey participants showed interest in spreading information about

Triple P through social media, flyers, email, or other means.

o 51% of survey participants were interested in learning more about becoming a Triple P

practitioner.

Difference by preferred language and gender

o Participants whose preferred language was Spanish reported greater improvement as a

result of services.

o Female participants reported greater overall satisfaction with Triple P services than male

participants.

Barriers to participating Triple P

o Reasons provided by six participants for not completing Triple P services included: medical

issues, scheduling conflicts, new employment, lack of time, co-parent dropped out, and

difficulty with the practitioner.

o Of those who completed their services but did not attend all sessions, work, child care

issues, and illness were mentioned most frequently. Other reasons included being too

busy, and relocation.

o While the majority of the reasons provided were not within the control of First 5 Santa

Cruz County or Triple P practitioners, the survey participants’ feedback will be taken into

consideration as practitioners schedule future classes and help clients troubleshoot

potential barriers to participating in Triple P services.

Summary

o Overall, a vast majority of survey participants reported experiencing significant and lasting

benefits of Triple P services. They reported an overwhelmingly positive experience with

the program, learned strategies they could use regularly in their parenting, and nearly all

participants were likely to recommend the services to family and friends.

98% of survey

participants would

recommend Triple P

to family and friends



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 2014-15.

Figure 72: Number and Types of Organizations with Accredited Triple P Practitioners, by Triple P Level (2014-2015)

LEVELS 2 & 3 LEVELS 4 & 5

TYPE OF ORGANIZATION NUMBER TYPE OF ORGANIZATION NUMBER

Private practitioner/therapist 7 Private practitioner/therapist 10

Health care 4 Health care 1

Family Resource Center 3 Family Resource Center 3

Special needs 3 Special needs 4

Counseling 2 Counseling 3

Early childhood education 1 Early childhood education 1

County Child Welfare 1 County Mental Health 1

County Mental Health 1 Education 1

County Employment & Benefit Services 1 Differential Response 1

Education 1 Substance abuse 1

Domestic violence 1 First 5 1

Differential Response 1 Youth development 1

Substance abuse 1 Number of Organizations 28

First 5 1

Number of Organizations 28 Source: Optimal Solutions Consulting, 2015.



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 165 practitioners have been accredited to provide Triple P services.

Figure 73: Number of Accredited Triple P Practitioners

COURSE TYPE

ACCREDITED DURING THIS FUNDING CYCLE

2014-2015

CUMULATIVE TOTALS

2009-2015

Level 2 Seminars Core (0-12) 1 20

Teen (13-16) 0 9

Level 3 Primary Care* Core (0-12) 16 95

Teen (13-16) 0 11

Stepping Stones 14 17

Level 4 Group Core (0-12) 1 39

Teen (13-16) 0 18


Level 4 Standard Core (0-12) 1 43

Teen (13-16) 0 40


Level 5 Enhanced 0 18

Level 5 Pathways 0 21

Level 5 Family Transitions 0 16

Total Number of Practitioners (unduplicated)

24 165

Source: Optimal Solutions Consulting, 2015. * 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 by:

Producing flyers for practitioners to promote their Triple P classes.

Promoting Triple P services through online calendars, newspapers, PSAs, Facebook, television

interviews and a monthly e-newsletter.

Distributing Triple P Parenting Pocket Guides at community outreach events and through

partner agencies.

Publicizing First 5’s main phone number as a “warmline,” or central place to receive

assistance with accessing Triple P services.

Conducting 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.

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 2014-2015 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 (Triple P services)

2014-2015(Participated in Triple P)


Parents/Guardians 347

AGES

0 – 5 AGES

6 – 12 AGES

13 – 16 AGES

17+

Children 160 124 33 15 332



Children (all ages) 1,204



Children (all ages) 20

TOTAL***


Children (all ages) 1,556

Source: (Consenting clients ) First 5 CCD database for July 1, 2014 – June 30, 2015; (Seminar & Workshop clients & Non-Consenting clients) First 5, Triple P Master Client Data Collection Template, 2015.


**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.


FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – LA MANZANA COMMUNITY RESOURCES


Figure 74: Types of Triple P Services Provided (LMCR: 2014-15)

Source: First 5, Triple P Master Client Data Collection Template, 2015.

Notes: Percentages include the services of clients who may have participated in multiple services, and the services to clients who did not consent to have their assessment data included in this evaluation. N=990.

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 2015) 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 received brief, one-on-one Triple P services (Level 3) reported increased

confidence in parenting, less difficulty with their children’s behavior, and increased enjoyment in

their parent/child relationship. An increase in support from partners was also reported by LMCR

clients who participated in brief Triple P services, as well as clients who participated in in-depth

Triple P sessions (Levels 4 and 5).

Figure 75: Increases in Positive Parenting (LMCR: 2010-2015)

Source: Triple P data from the Parenting Experience Survey, Questions 3, 6, 1, and 2, analyzed by Applied Survey Research, Jan. 2010 - June 2015. 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. 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).

11.6%

19.2%

50.4%

3.1%

7.5%6.5%

1.7%Level 2 Seminar

Level 2 Individual

Level 3 Workshop

Level 3 Individual/Brief Group

Level 4 Standard

Level 4 Group

Level 5 Family Transitions

3.4 3.53.1

3.84.2 4.0 3.9 4.2

0

1

2

3

4

5


Support from Partner in theirRole As a Parent* (N=275)



Pre PostExtreme

Not at all





LMCR clients who completed Levels 4 and 5 of the Triple P program reported an increase in their use

of positive parenting styles.

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 through

the course of the Triple P program.




Figure 76: Parents’ Use of Positive Parenting Styles (LMCR: 2010-2015)



After completing the Triple P program, LMCR clients on average indicated that there were


On average, All Parents and all analyzed sub-populations (except Caucasians) tended to score

above the clinical cut-off at the beginning of the program, and ended the program out of a

range of concern.




3.4 3.2 3.4 3.43.0

3.5 3.22.7 2.7 2.8 2.8

2.42.9

2.5

1

2

3

4

5

6

7


Male**(N=83)

Female**(N=255)

Latino**(N=275)

Caucasian**(N=44)

Spanish**(N=213)

English**(N=115)

Pre PostLess positive

More positive

Lower is

“Better”



Figure 77: Number of Parenting Issues That Have Been a Source of Conflict Between Parents (LMCR: 2010-2015)



On average, All Parents and all sub-populations participating in Triple P at LMCR significantly

lowered their level of depression, anxiety, and stress.




An analysis of Effect Sizes showed that on average, parents with scores in the Clinical Range

of Concern at Pre-test experienced a moderate to large magnitude of change. These results

indicate that for this sub-population, these observed differences were not only statistically

significant but also meaningful.

Figure 78: Level of Parental Depression, Anxiety, and Stress (LMCR: 2010-2015)

Depression

5.8

8.6

5.7 5.9 6.14.5

6.1 5.33.3 4.6 3.0 3.4 3.4 2.8 3.4 3.1

0

4

8

12

16



(N=137)

Male**(N=74)

Female**(N=162)

Latino**(N=196)

Caucasian**(N=30)

Spanish**(N=149)

English**(N=82)

Pre Post

9.5

23.0

7.8 10.1 9.6 9.4 10.3 7.86.211.3

6.0 6.2 6.34.9

6.84.80

7

14

21

28

35

42

All Parents*(N=350)


(N=97)

Male*(N=89)

Female*(N=261)

Latino*(N=286)

Caucasian*(N=44)

Spanish*(N=218)

English*(N=121)

Pre Post


Clinical Cut-Off:

>5

Lower is

“Better”



No distress

Clinical Cut-offs:

Very Severe >=28

Severe >= 21

Moderate >=14

Lower is

“Better”



Anxiety

Stress



After completing the Triple P Program at LMCR, parents reported a decrease in the frequency and

number of problematic child behaviors.

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 (except Males) began with scores within the clinical range, and ended with

scores that were out of the clinical range.




8.0

18.3

6.08.7

8.2 6.8 8.7 6.45.5 9.44.9 5.7 5.6 4.0

5.94.30

7

14

21

28

35

42

All Parents*(N=350)

ClinicalRange at

PreTest**(N=121)

Male(N=89)

Female*(N=261)

Latino*(N=286)

Caucasian*(N=44)

Spanish*(N=218)

English*(N=121)

Pre Post

12.7

27.6

9.913.6 12.5

14.212.5 12.6

8.5

13.7

7.7 8.7 8.4 8.1 8.5 8.00

7

14

21

28

35

42

All Parents*(N=349)

ClinicalRange at

PreTest**(N=80)

Male*(N=89)

Female*(N=260)

Latino*(N=285)

Caucasian**(N=44)

Spanish*(N=217)

English**(N=121)

Pre Post


No distress

Clinical Cut-offs:

Very Severe >=20

Severe >=15

Moderate >=10


No distress

Clinical Cut-offs:

Very Severe >=34

Severe >=26

Moderate >=19

Lower is

“Better”

Lower is

“Better”



Figure 79: Number of Child Behaviors Perceived to Be a Problem (LMCR: 2010-2015)




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 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 (6.55), and with the quality of the service they

and their child received (6.54, on a 7-point scale).

The average parent satisfaction ratings for Level 3

Workshops ranged from 4.69 to 4.78, and Level 2

Seminars ranged from 4.75 to 4.84, 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.

16.2

23.0

14.0 16.9 16.4 15.5 16.6 15.0

7.8 10.96.4 8.3 8.0 7.5

8.6 6.20

6

12

18

24

30

36



(N=175)

Male**(N=76)

Female**(N=238)

Latino**(N=261)

Caucasian**(N=35)

Spanish**(N=204)

English**(N=102)


a problem


Clinical Cut-off:

>=15

Lower is

“Better”


“I enjoyed learning ways to deal with my child’s tantrums, and to positively improve communication.”

“I have practiced what I learned in class, about how to communicate with words and not reacting. It works for me.”

“I really liked how I was always offered ‘tools’ to work with my child. I would learn and practice at home with my child. I have gotten great results and my child has greatly improved in her behaviors!”

“I’m very pleased with the help I have received. I would definitely recommend these services to another father.”

- Triple P Client Satisfaction Surveys



Figure 80: Parents’ Satisfaction with Various Aspects of the Triple P Program (LMCR: 2010-2015)



Level 3 Workshops

Source: Triple P data from the Workshop Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015.


Level 2 Seminars

Source: Triple P data from the Seminar Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015.


N=389.

6.36

6.48

6.55

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=502)




4.78

4.77

4.69

1 2 3 4 5

3. Overall I was satisfied with the workshop.(N=1,462)

2. I am likely to use some of the parentingstrategies in the tip sheet. (N=1,454)

1. The workshop answered a question or concernI have had about parenting. (N=1,460)

4.81

4.84

4.75

1 2 3 4 5

3. Overall I was satisfied with the seminar

2. I am likely to use some of the parentingstrategies in the tip sheet.

1. The seminar answered a question or concernI have had about parenting.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES 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, Scotts Valley, and Santa Cruz 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 (Triple P services)

2014-2015(Participated in Triple P)



AGES

0 – 5 AGES

6 – 12 AGES

13 – 16 AGES

17+

Children 39 46 22 6 113





Parents/Guardians 3


TOTAL***



Source: (Consenting clients ) First 5 CCD database for July 1, 2014 – June 30, 2015; (Seminar & Workshop clients & Non-Consenting clients) First 5, Triple P Master Client Data Collection Template, 2015.


**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.


PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT STRONG FAMILIES – MOUNTAIN COMMUNITY RESOURCES


Figure 81: Types of Triple P Services Provided (MCR: 2014-15)

Source: First 5, Triple P Master Client Data Collection Template, 2015.

Notes: Percentages include the services of clients who may have participated in multiple services, and the services to clients who did not consent to have their assessment data included in this evaluation. N=212.

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 2015) 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 Caucasian and English-speaking. Consequently, the Latino and

Spanish-speaking subpopulations do not yet have enough assessment data to analyze.


MCR clients who completed Levels 4 and 5 of the Triple P program reported an increase in their use

of positive parenting styles.

On average, for All Parents and sub-populations with enough clients to analyze (Male,

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 through 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


28.8%

36.3%

5.4%

27.6%

1.9%

Level 2 Seminar

Level 3 Workshop

Level 4 Standard

Level 4 Group

Level 5 Family Transitions



Figure 82: Parents’ Use of Positive Parenting Styles (MCR: 2010-2015)



After completing the Triple P program, MCR clients on average indicated that there were





Although the Male sub-population demonstrated reduced levels of conflict, on average the

amount of improvement was not significant.

Figure 83: Number of Parenting Issues That Have Been a Source of Conflict Between Parents (MCR: 2010-2015)


3.0 3.0 3.0 2.93.0

2.3 2.4 2.3 2.3 2.31

2

3

4

5

6

7

All Parents**(N=70)

Male **(N=26)

Female**(N=44)

Caucasian**(N=55)

English**(N=64)

Pre Post

7.8 8.9 7.7 7.9 7.1 7.5

5.8 6.4 6.5 5.4 5.4 5.8

0

4

8

12

16

All Parents**(N=65)


(N=54)

Male(N=24)

Female**(N=41)

Caucasian**(N=51)

English**(N=60)

Pre Post

Less positive

More positive

Lower is

“Better”


Clinical Cut-Off:

>5

Lower is

“Better”





On average, All Parents and most sub-populations (Females, Caucasians, and English-

speaking clients) participating in Triple P at MCR significantly lowered their level of

depression, anxiety, and stress.




Levels of stress were particularly improved. An analysis of Effect Sizes showed that on

average, All Parents and most sub-populations (Females, Caucasians, and English-speaking

clients) experienced a moderate to large magnitude of change in their levels of stress. These

results indicate that for these sub-populations, observed differences were not only

statistically significant but also meaningful.

Figure 84: Level of Parental Depression, Anxiety, and Stress (MCR: 2010-2015)

Depression

Anxiety

8.4

24.3

4.410.7

8.1 8.05.09.7

4.7 5.2 4.9 5.20

7

14

21

28

35

42

All Parents*(N=70)


(N=12)

Male(N=26)

Female**(N=44)

Caucasian*(N=55)

English*(N=64)

Pre Post

7.1

17.7

4.1

9.06.7 6.8

3.87.4

3.3 4.1 3.8 4.00

7

14

21

28

35

42

All Parents*(N=70)


(N=22)

Male(N=26)

Female**(N=44)

Caucasian*(N=55)

English*(N=64)

Pre Post


No distress

Clinical Cut-offs:

Very Severe >=28

Severe >= 21

Moderate >=14


No distress

Clinical Cut-offs:

Very Severe >=20

Severe >=15

Moderate >=10

Lower is

“Better”

Lower is

“Better”



Stress



After completing the Triple P Program, MCR clients reported a decrease in the number of child

behaviors that were perceived to be a problem.

On average, for All Parents and sub-populations with enough clients to analyze, there was a

significant reduction in the number of child behaviors that were perceived to be a problem.


Concern at Pre-test, and Males. Parents in these sub-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 significant results also exhibited a

moderate to large magnitude of change. These results indicate that these observed


16.1

25.6

13.517.7 16.0

16.3

10.514.3

10.6 10.5 10.7 11.1

0

7

14

21

28

35

42

All Parents**(N=70)


(N=28)

Male*(N=26)

Female**(N=44)

Caucasian**(N=55)

English**(N=64)

Pre Post


No distress

Clinical Cut-offs:

Very Severe >=34

Severe >=26

Moderate >=19

Lower is

“Better”



Figure 85: Number of Child Behaviors Perceived to Be a Problem (MCR: 2010-2015)




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 high

levels of satisfaction with various aspects of the

program experience. On average, parents gave the

highest rating to the question, “How would you rate

the quality of the service you and your child received?”

(6.49, on a 7-point scale).

The average parent satisfaction ratings for Level 3

Workshops ranged from 4.44 to 4.73, and Level 2

Seminars ranged from 4.27 to 4.72, 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.

14.4

19.1

15.4 13.9 14.8 14.9

8.5 10.4 9.57.9 8.6 8.8

0

6

12

18

24

30

36

All Parents**(N=68)

Clinical Range atPreTest**

(N=39)

Male**(N=25)

Female**(N=43)

Caucasian**(N=55)

English**(N=63)


a problem


Clinical Cut-off:

>=15

Lower is

“Better”


“I just wanted to thank you for this Triple P class, that taught us how to talk to our teens.”

“I really like the “no hitting” principle and the concept of measured response vs. escalation.”

“I really enjoyed this class. I learned effective skills that I saw make a positive difference in my child and myself.”

- Triple P client feedback



Figure 86: Parents’ Satisfaction with Various Aspects of the Triple P Program (MCR: 2010-2015)



Level 3 Workshops

Source: Triple P data from the Workshop Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015. Note: All items were on a 5-point scale. Higher scores indicate greater satisfaction.

Level 2 Seminars

Source: Triple P data from the Seminar Satisfaction Survey, analyzed by Applied Survey Research, Jan. 2010 - June 2015. Note: All items were on a 5-point scale. Higher scores indicate greater satisfaction.

6.15

6.30

6.36

6.49

1 2 3 4 5 6 7

11. Has the program helped you to develop skills that can be appliedto other family members? (N=73)




4.67

4.73

4.44

1 2 3 4 5

3. Overall I was satisfied with the workshop.(N=363)

2. I am likely to use some of the parentingstrategies in the tip sheet. (N=364)

1. The workshop answered a question orconcern I have had about parenting. (N=366)

4.54

4.72

4.27

1 2 3 4 5

3. Overall I was satisfied with the seminar.(N=263)

2. I am likely to use some of the parentingstrategies in the tip sheet. (N=265)

1. The seminar answered a question orconcern I have had about parenting. (N=264)

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT STRONG FAMILIES – SIDE-BY-SIDE


“Side-by-Side staff is most proud of the way we are able to improve many areas of functioning for children 0-5 in this county through the unique design of the program. Through education, training, and support of early child care providers, parents, and caregivers, and through age-appropriate expertise in providing therapeutic services to these children, our program is truly able to bolster the next generation and prevent future difficulties such as school failure, poor health, and incarceration.

One child care provider who worked with our program this year summed up her experience with Side-by-Side in the following way:

‘I feel fortunate to have this direct support from a specialist who has direct contact with the child and with her family. She (the specialist) helped me learn different ways of helping children who need it.’”

- 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 in child care settings. 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

challenges. 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 clinicians/consultants (SBS

Clinicians) provide recommendations to teachers and additional follow-up, as needed.

Population Served

2014-2015

Staff/Child Care Providers 49


Children 27

Source: (Parents/Guardians) Side by Side 2014-15 Annual Progress Report; (Children) First 5 CCD database for July 1, 2014 – June 30, 2015.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES STRONG FAMILIES – SIDE-BY-SIDE


Outcome Objective: Children participating in “Family Services” will receive developmental screening and be assessed for behavioral and emotional problems

2014-2015

90% of all families receiving Family Services from the Side-by-Side Program will complete the ASQ/ASQ-SE and/or CANS.

ASQ 88.9%

N=27

CANS/CBCL* 74.1%

N=27

Source: Side by Side 2014-15 Annual Progress Report.

* The CANS assessment was not officially implemented until fall 2014, so the CBCL was used as the “Pre” assessment until that time. The CBCL was also utilized for “Post” measurements if it had been utilized as a “Pre” measurement.

Outcome Objective: Families participating in “Family Services” will report improvements in child behavior

2014-2015

1. 85% of eligible families completing between 8-12 psychotherapy/counseling meetings will complete the CANS* as a pre-/post-intervention measures.

90.0%

N=10

2. Of those completing both a pre and post CANS*, 75% will demonstrate improvement in at least one measure.

100%

N=9

Source: Side by Side 2014-15 Annual Progress Report.

* The CANS assessment was not officially implemented until fall 2014, so the CBCL was used as the “Pre” assessment until that time. The CBCL was also utilized for “Post” measurements if it had been utilized as a “Pre” measurement.

Based on results of the assessments, children and families are provided information, support, and—

if needed—case management services by the SBS Coordinator to seek and attain further evaluation.

Through the assessments completed this past program year (ASQ, CANS, and Mental Health

Assessment), program staff were able to determine that some children showed developmental

concerns, and referrals were made for further evaluations at the children’s school districts and with

the children’s physicians, when appropriate. Their families received on-going support and advocacy

to complete the evaluation process with other agencies. Of the nine children assessed to need

further evaluation, four children are now attending a special day class based on their disability, eight

children are receiving speech therapy, and one child is receiving further evaluation by a neurologist.

The majority of all eligible families completed counseling, 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.

Outcome Objective: Children participating in “Site-based” services will have their needs evaluated and addressed

SBS Clinicians try to serve as many families as possible from a “Family-based” model, as outcomes

are improved when parents are consistently involved. However, there are circumstances when they

offer “Site-based” services when the “Family-based” model is not feasible. In 2014-15, three

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT STRONG FAMILIES – SIDE-BY-SIDE


children received “Site-based” services, and one of these three later moved to “Family-based”

services when the parent was able to commit to more intensive work with the Clinician.

“Site-based” services typically begin if the staff have concerns about the child’s emotional well-

being, or if they see increases in the child’s disruptive behaviors. Often there is knowledge of family

challenges, including ongoing CPS investigations, or parents with their own mental health concerns.

In one case, although the lead teacher was highly skilled and experienced, she reported that she had

never seen such difficult behavior from a child and was seeking further support. At this point, the

SBS Clinician attempts to engage the parents and as rapport with the parents increase, they are

more willing to engage in family counseling and parenting support.

The SBS Clinician begins providing consultation services to both the staff and the parents via

classroom observations, face-to face consultations, and phone consultations. Suggestions and

consultations with the staff have included strategies to reduce the child’s anxiety, adjustments to

their expectations of the child’s classroom participation, learning how to minimize triggers for the

child, and how to provide a consistent and safe nurturing environment. A better understanding of

the parents by school staff has often reduced stigmatization of the family and allowed for more

inclusion.

Suggestions to the parents have included seeking further evaluation for their child through the

child’s school district and/or family physician, reducing stressors in their living situation, practicing

coping skills to reduce their own anxiety, and parenting tools to provide more consistency and

follow-through to reduce the children’s aggressive behaviors.

The results are inspiring and encouraging. Teachers report that they have gained awareness and

understanding of the child’s needs, have shifted their expectations, increased their empathy for the

child, and have found strategies that decrease the child’s disruptive behavior.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL - QUALITY EARLY LEARNING INITIATIVE



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

“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

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT 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 professionals 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 2014-15, there were 46 state and federally funded

sites with 57 classrooms (from 11 child development programs) and 23 Family Child Care homes

participating in Race to the Top quality efforts in Santa Cruz County.

In 2013-14, California’s RTT-ELC grant released supplemental funds to each participating county,

allowing First 5 Santa Cruz County to increase the number of Family Child Care homes served and

provide additional coaching and technical assistance through June 2016.

Figure 87: Distribution of RTT-ELC Sites in the County (2014-15)

Source: First 5 Santa Cruz County, 2014-15.

California has taken a unique approach that allows 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 aligns their

local QRIS to a common “Quality Continuum Framework” and follows an implementation guide to

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.



Population Served

2014-2015

Providers who attended a RTT Workshop and received a stipend

92

Family Child Care providers who received a stipend to participate in RTT-ELC

23


Child Signature Program (CSP) 27

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).

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 17

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 is 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.

27

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.

“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



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 26 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 rating based on their cumulative

scores in all seven elements 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.










Figure 88: Ratings of QRIS Sites in Santa Cruz County

NUMBER OF SITES WITH THIS RATING

QUALITY TIER DEC. 2013 PROVISIONAL RATINGS DEC. 2014 PROVISIONAL RATINGS

Tier 1 0 0

Tier 2 0 23

Tier 3 24 17

Tier 4 16 28

Tier 5 0 1

Total sites 40 69 Source: First 5 Santa Cruz County, 2015. Note: The initial ratings of Santa Cruz County’s sites are considered to be “Provisional” rather than “Full,” since no sites had yet received both an independent Classroom Assessment Scoring System AND Environmental Rating Scale assessment as of December 2014.



Quality Improvement Activities

First 5 contracted with Encompass Community Services to lead the QELI Consortium’s quality

improvement activities for center programs, 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 Community Services coordinated trainings related to CSP and RTT-

ELC, provided technical assistance to program directors, maintained centralized records,

coordinated independent assessments, and conducted the QRIS ratings. First 5 contracted with Go

Kids, Inc. to lead the QELI Consortium’s quality improvement activities for Family Child Care (FCC)

homes. The Go Kids, Inc. FCC manager recruited FCC providers to RTT-ELC, completed provisional

baseline ratings, and coordinated trainings and independent assessments.











9 directors
















Bay Area Quality Early Learning Partnership (BAQELP)

Santa Cruz County has joined with Santa Clara, San Francisco, Alameda, Contra Costa, and San

Mateo counties to form the Bay Area Quality Early Learning Partnership (BAQELP). This regional

consortium was developed so that these neighboring counties could strategize together, share

resources, leverage funds, and align practices. This regional approach has resulted in strengthening

the current resources available for professional development and independent assessment.

The counties in this consortium continue to develop and share a common data system called the

WELS Bay Area Regional RTT Database, which is 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.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL - STARLIGHT CHILDREN’S CENTER


Starlight Children’s Center

Program Description

The Starlight Children’s Center (SCC) provided early childhood and family development services to

families of children 0-3 years old, and offered a wide variety of comprehensive bilingual services for

expectant parents and families with infants and toddlers. It was 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

was to create a “learning community” that promoted early

literacy and social/emotional skills to help lay a solid

foundation for school readiness.

The program provided center-based services for 10

children, through collaborative funding with the Early Head

Start Program, and operated four days per week for six

hours per day. In addition, the program provided 20

families with home-based services which included weekly

home visits and two socializations per month. Both center-

and home-based services followed the criteria for the federally funded Early Head Start program,

and SCC families received priority enrollment into Head Start pre-school classes once the child

turned three years old.

Both the center- and home-based teachers utilized 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 were augmented through a wide variety of

additional supports that included literacy, health, and early childhood development information.

These activities included speakers, special trainings and family literacy classes.

Population Served

2014-2015

Parents/Guardians (Total) 48

(Pregnant clients) 2(Parents/Guardians) 46

Children (Total) 32

(Center-based) 9(Home-visited) 23

Source: First 5 CCD database for July 1, 2014 – June 30, 2015; Starlight Children’s Center, Annual Progress Report, 2014.

“This program serves the most vulnerable children in our community. Our mission is to provide support services to families who have children who are at risk for negative child outcomes. Our work is founded on the principles of supporting the neediest of the needy. Our work focuses on supporting at-risk children so that they have what they need to succeed in school.”

- Starlight Children’s Center, Annual Progress Report

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL - STARLIGHT CHILDREN’S CENTER


Outcome Objective: Pregnant clients will receive prenatal support and education

2014-2015

By June 30, 2015, 80% of pregnant women will make a positive lifestyle change such as decreased caffeine intake, smoking cessation, increased exercise, and increased information regarding health and wellness.

100% N=2

By June 30, 2015, 75% of pregnant women will keep all prenatal appointments and will keep all postpartum follow-up visits and first newborn doctor visits.

100% N=2

Source: Starlight Children’s Center, Annual Progress Report, 2015.

Outcome Objective: Parents will expand their literacy activities with their children

2014-2015

Between July 1, 2014 and June 30, 2015, 100% of all participating families will complete an initial assessment, a family partnership agreement, a nutritional assessment, and health and dental screenings (within 60 days of enrollment and reviewed quarterly).

100% N=30

By June 30, 2015, 80% of parents will report an increase of activities with their children that stimulate their child’s development.

93.8% N=48

By June 30, 2015, 90% of home-visited families will identify family literacy goals in their Family Partnership Agreement.

96.7% N=30


Outcome Objective: Children’s development will be assessed

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 worked with parents of infants and

toddlers to build the foundations for literacy. To guide their efforts with children and their families,

they assessed children’s health and development using the Ages and Stages Questionnaire (ASQ) and

ASQ: Social/Emotional (ASQ:SE) screening tools, the DRDP – Infant/Toddler (2010) for children who

received center-based services, and the New Portage Guide for children who received home-based

services.

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL - STARLIGHT CHILDREN’S CENTER


2014-2015

By June 30, 2015, 100% of enrolled children will be screened in developmental and social-emotional areas using the ASQ/ASQ/SE (within 30 days of enrollment).

Within 30 days of enrollment:

Within 35 days of enrollment:

93.8% N=32

100% N=32

By June 30, 2015, 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 (within 60 days of initial screening).

100% N=5

By June 30, 2015:

Center-based: Center-based children ages 0-3 will be assessed using the Desired Results Developmental Profile for Infants and Toddlers (DRDP-I/T). Program staff will work with Desired Results to create reports that will provide clear analysis of assessment data.

Home-visited: Children enrolled in the home visiting program ages 0-3 will be assessed using selected indicators from the Portage Assessment Tool.

Assessments for both center-based and home-visited children will be conducted and analyzed three times a year in October (Fall), February (Winter), and June (Spring). 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.

Center-based children (N=9)

44% of children completed the first two DRDP-I/T assessments

22% completed all three assessments*

Home-visited children (N=23)

61% of children completed the first two New Portage Guide assessments

0% completed all three assessments


* Spring DRDP-I/T results were not available at the time of this report.

Results

DRDP-I/T

Assessment results showed that toddlers in the Starlight Children’s Center were supported to

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

Figure 89: Changes in Levels in Key Developmental Areas (2014-15)

Source: Starlight Children’s Center, Annual Progress Report, DRDP-I/T Results, 2014-2015.

* Spring DRDP-I/T results were not available at the time of this report.

N=9. Due to the low number of clients, results should be interpreted with caution.

5.6

4.0 4.0

4.8

4.0

5.9

4.6 4.5

5.3

4.5

1

2

3

4

5

6

Motor and PerceptualDevelopment

Health Self and SocialDevelopment

Language andLiteracy

CognitiveDevelopment

Fall

Winter

Spring*

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL - STARLIGHT CHILDREN’S CENTER


New Portage Guide

The New Portage Guide Birth to Six was a developmental assessment tool based on direct

observations of typical milestone skills in five domain areas:

Communication/language/literacy

Exploration/approaches to learning

Purposeful motor activity

Sensory organization

Social/emotional development

Children were rated in these areas as either: No/Not observed, Occasionally/Emerging Skill

area, or Consistently/Mastered. “Mastery” of an indicator meant that the child consistently

demonstrated the skill in a variety of settings. Assessments were completed three times a

year for each child to document their growth and development, measure progress, and plan

individualized learning activities with parents and in socialization group settings.

In 2014-15, children demonstrated growth in all domain elements.

Children ages 9-18 months showed the greatest growth in “Exploration/approaches to learning.”

For children between the ages of 18-36 months the greatest growth was in “Social/emotional development” and “Sensory organization.”

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES 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 proficiency, 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.”28

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 early childhood educators working in center-based Pre-K and

TK sites through SEEDS of Early Literacy training and coaching. Educators earn a stipend,

receive on-site coaching, and attend literacy labs. This program is described in more detail in

the following pages.

2. Professional development for family child care providers working with Spanish-speaking

children through SEEDS of Early Literacy training and coaching. Training includes

28

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.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL - EARLY LITERACY FOUNDATIONS INITIATIVE


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.

3. Development and expansion of the Santa Cruz Reading Corps. This program places

AmeriCorps volunteers (called a Literacy Tutors) in each State Preschool classroom in the

Pajaro Valley Unified and Live Oak school districts, and also in a growing number of

Transitional Kindergarten classrooms in these districts. The goal of this program is to

develop children’s early literacy skills in English in preparation for kindergarten. The 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 and

TK classrooms via the Individual Growth and Development Indicators (IGDIs) tool. These

assessments help teachers identify children who need individualized instruction in early

literacy strategies. Since 2013-14, only State Pre-K classrooms with Reading Corps tutors

have been using these assessments to this level of intention.

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) “Toddler Time,” a program offered at six branches,

provides 60 minutes of moderately unstructured play and activity time, including early

literacy development with stories and songs to engage very young children and families in

early literacy activities.

The following descriptions provide more detailed information about the SEEDS of Early Literacy 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. Early childhood educators are taught to use the 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 classroom 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.

Santa Cruz County’s SEEDS of Early Literacy program has 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.



In 2014-15 First 5 Santa Cruz County offered SEEDS programs to two different populations of early

childhood educators:

SEEDS for Center-based Pre-K and TK Teachers

This program provides professional development for early childhood educators working in Pre-K and

Transitional Kindergarten (TK) centers. In an effort to support teachers as they work to include the

SEEDS concepts into daily practice, this nine-month course is designed to focus on the SEEDS strategies

through embedded and explicit instruction, modeling, practice, and one-on-one coaching throughout

the academic year.

Each participant in SEEDS for Center-based Pre-K/TK receives:

16 three-hour instructional sessions Pre and Post literacy environment assessment

12 two-hour on-site coaching visits 4 literacy labs and 6 children’s books to use in their centers 2 optional literacy labs

SEEDS for Family Child Care Providers

This program provides professional development for family child care providers working with

Spanish speaking children through SEEDS of Early Literacy training and coaching. The training uses

the SEEDS Parent curriculum, with a focus on working with children from birth to kindergarten. This

program offers five Make and Take workshops in the fall, and again in the summer for migrant

providers (beginning in June).

Each workshop includes:

1½ hours of instruction 2½ hours to create literacy-based materials to use in the family child care home 5 one-on-one coaching sessions in the home Pre and post literacy environment assessments 5 children’s books to use in their program 1 model SEEDS classroom/FCC home tour

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 AmeriCorps29 to create the Santa Cruz Reading Corps (SCRC),

with the goal of training and placing AmeriCorps volunteers in state

preschool and transitional kindergarten classrooms in both the Live Oak and

Pajaro Valley Unified School Districts. The SCRC is modeled after the

Minnesota Reading Corps, the largest single state AmeriCorps initiative in the country.

29

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.



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 proficiency, 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 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 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.

One Literacy Tutor’s Story

“At the beginning of the school year Jose had almost no language skills. I grouped Jose with two other boys who had similarly low levels of language skills and began reading books and doing vocabulary building activities with them every day.

For a long time Jose was uninterested in participating, but eventually he grew to enjoy it. Halfway through the year Jose started asking me to read to him and would go fetch the other boys in the group to come listen. He started speaking in single words, and then sentence fragments. The most exciting development in Jose's progression is that about two months ago he started asking me ‘why?’ all the time (and every time I enthusiastically answer him).

Learning is no longer a discouraging activity for him and he now feels free to explore his curiosity. Jose finally feels empowered as a learner.”



Early Literacy Foundations (ELF) Initiative

Population Served

THIS

FUNDING

CYCLE

2014-2015

CUMULATIVE

TOTALS

2007-2015

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

15 53

Number of early childhood educators attending SEEDS of Early Literacy courses 40 455

Number of early childhood educators attending the SEEDS Plus program* 0 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 14 29

TOTAL (unduplicated) 69 639**

CHILDREN

Number of children in classrooms with a Reading Corps tutor 601 1,472

Source: First 5 CCD database for July 1, 2014 – June 30, 2015; Early Literacy Foundations (ELF) Initiative, 2007-15.

* The SEEDS Plus program was offered from 2011-2013, and was designed for “graduates” of the early SEEDS of Early Literacy classes. This course was designed to promote and embed the ongoing use of SEEDS strategies, identify children who would receive tailored literacy-based interventions (using Response to Interventions (RtI) strategies), and increase the number of children on target with early reading predictors. Currently, SEEDS skills are incorporated into all SEEDS of Early Literacy trainings for SEEDS coaches and early childhood educators, without the use of RtI.

** In 2011-12, no formal SEEDS workshops were provided to FFN informal child care providers. However, approximately 45 FFN informal child care providers participated in a weekly “read aloud” group that modeled early literacy strategies. No personal information was collected for these 45 FFN informal child care providers. Therefore, these cumulative totals likely include duplicated clients.

The following figures show additional data about early childhood educators who have been trained

in the SEEDS of Early Literacy between 2007-2015.

Figure 90: Number of SEEDS-Trained Early Childhood Educators in Licensed Programs, by type of classroom (2007-2015)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, 2007-2015.


Educators in State and

Federally-Subsidized Classrooms

Educators in Licensed Family Child Care Homes

and Private/Non-Profit Centers

Total Number

(Unduplicated)

209 214 15

Educators in Public School

Transitional Kindergarten Classrooms

438



Figure 91: Key Demographics of SEEDS-Trained Early Childhood Educators in Licensed Programs (2007-2015)

Primary Language

Educational Attainment

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Client and Assessment Data Entry Template, 2007-2015.


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=446; (Education) N=414.

Outcome Objective: Increase the number of early education settings that provide high quality support for language and literacy

Preschool and Transitional Kindergarten (TK) 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.”

27.1%

48.7%

21.7%

2.5%

English Only

Spanish Only

Bilingual English/Spanish

Other

8.7%

9.7%

20.3%

27.1%

6.3%

10.6%

8.5%

4.1%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 that 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 have used varying elements

of 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 Across all components, classrooms showed improvements from the beginning of the semester to

the end.

Overall, the percentage of classrooms that were rated as having High-Quality Support

increased from 20% to 93%.

The classroom component where the most change occurred was in “Language Environment,”

where the percentage of classrooms rated as having High-Quality Support increased from 0%

at the beginning of the semester to 93% by the end of the semester.

Figure 92: Preschool and Transitional Kindergarten Classrooms: Support for Language and Literacy (2014-2015)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Early Language and Literacy Classroom Observation (ELLCO) Pre-K, 2014-2015 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 and early childhood educators who attended SEEDS of Early Literacy courses; classrooms with Reading Corps tutors are not included. N=15.

13.3%6.7%

13.3% 13.3%20.0%

6.7%

46.7%

6.7%

73.3%

13.3%

86.7%

6.7%

60.0%

6.7%

60.0%

20.0%

73.3%

6.7%

40.0%

93.3%

20.0%

86.7% 93.3%

26.7%

93.3%

20.0%

80.0%

20.0%

93.3%

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 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” (94%),

“Approaches to Curriculum” (89%), “Approaches to Book Reading” (88%), and “Support for

Children's Writing” (88%).

The classroom component where the most change occurred was in “Support for Children's

Writing,” where the percentage of classrooms rated as having High-Quality Support

increased from 31% at the beginning of the semester to 88% by the end of the semester.

Similar increases were found with “Approaches to Book Reading” and “Approaches to

Curriculum.”

Figure 93: Preschool and Transitional Kindergarten Classrooms: Key Language and Literacy Supports (2007-2015)

Source: First 5 Santa Cruz County Early Literacy Foundations program records, Early Language and Literacy Classroom Observation (ELLCO) & ELLCO Pre-K, 2007-2015.

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 and early childhood educators who attended SEEDS of Early Literacy courses.

N: (Child Choice and Initiative) N=214, (Book Reading) N=295, (Children's Writing) N=301, (Approaches to Curriculum) N=214.

* The analysis of these questions marked with an asterisk began in 2007-08, so results reflect the combined data since 2008.

9.8% 15.9% 18.9% 21.5%

38.8%

5.6%

51.5%

10.8%

50.5%

11.6%

43.9%

10.7%

51.4%

94.4%

32.5%

88.1%

30.6%

88.0%

34.6%

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 previous data 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 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.

The 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).

For this analysis, several years of data have been aggregated30 in order to present a more robust

portrait of the extent to which SEEDS-trained early childhood educators in family child care settings

were providing high quality support for language and literacy in their preschool classrooms.

Results

The following figures present the PRE and POST scores gathered from 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 44%

to 89%.

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 all areas:

“Physical Environment for Learning” (93%), “Support for Learning” (87%), 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 40% to 56%.

30

Between 2008-2011, early childhood educators in family child care settings did not use the CHELLO, and consequently no CHELLO data were collected during those years. Therefore, this analysis represents the results for the years that the CHELLO has been utilized (2007-2008, and 2011-present).



Figure 94: Family Child Care Settings: Support for Language and Literacy (2007-2015)

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), 2007-2015

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.

N: (Physical Environment for Learning)=40; (Support for Learning)=39; (Adult Teaching Strategies)=36; (Group/Family Observation Overall)=36; (Literacy Environment Checklist)=55.

7.5% 10.3%

38.9%

13.9%

42.5%

5.0%

28.2%

12.8%

27.8%

22.2%

41.7%

8.3%

50.0%

92.5%

61.5%

87.2%

33.3%

75.0%

44.4%

88.9%

0%

20%

40%

60%

80%

100%

Pre Post Pre Post Pre Post Pre Post


7.3%

52.7%

41.8%

40.0%56.4%

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



Outcome Objective: Children will increase their skills in research-based predictors for reading success

The Santa Cruz Reading Corps (SCRC) places one AmeriCorps volunteer (called a Literacy Tutor) in

each State Preschool and TK classroom at Live Oak School District, and in each State Preschool

classroom and one TK classroom at Pajaro Valley Unified School District. The goal of this program is

to develop children’s early literacy skills in English in preparation for kindergarten. The 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. In 2014-15, 14 Literacy Tutors were trained and placed in 24

different classrooms31, serving 601 children.

Santa Cruz Reading Corps’ Literacy Tutors are trained in the use of Response to Interventions (RtI)

strategies as a way to provide children with tailored literacy support. 32 Literacy Tutors assess

children’s pre-literacy skills in five areas: Picture Naming, Rhyming, and Alliteration (as measured by

the Individual Growth and Development Indicators (IGDIs)), and Letter Naming and Letter Sounds (as

measured by the Formative Assessment System for Teachers (FAST)). These assessments help the

Tutors recognize children who need tailored literacy support and respond in ways that help the

children experience early school success.

There are three important factors to note regarding these analyses of children’s pre-literacy skills:

Focus on English skills. Beginning in 2012-13, there was an emphasis in all “SEEDS”

classrooms on developing and improving children’s vocabulary skills in English. As the

majority of preschool students were dual language learners, many children were initially

assessed in both English and Spanish. Once these children demonstrated proficiency in their

scores on the English-language assessments, however, they did not continue taking the

Spanish-language assessments. Therefore, the analyses in this report illustrate the amount of

improvement that children made in their English pre-literacy skills.

Focus on children about to enter kindergarten. Only children ages 4 and 5 were included in

these IGDIs analyses, in order to focus on children who were at a similar developmental age

just before entering kindergarten. Additionally, the companion assessment given along with

the IGDIs assessment (the Formative Assessment System for Teachers) is not designed for

children younger than 4, which provided a framework for focusing on children ages 4 and 5.

31

Many classrooms offer services to more than one cohort of children a day. In 2014-15, across 16 sites, there were 24 different cohorts of children.

32 Children who received tailored literacy-based intervention strategies received more frequent monitoring. In addition to the three

benchmark IGDIs assessments, these children took two additional assessments between the 1st and 2

nd benchmark assessments (called

Progress Monitoring 1 and 2), and then two more assessments between the 2nd

and 3rd

benchmark assessments (called Progress Monitoring 3 and 4). If a child demonstrated sufficient improvement by the 2

nd 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 Monitoring 3 and 4). Consequently,

every child who received an intervention was monitored at least two additional times with the Progress Monitoring assessments.



Cumulative results. Several years of data have been aggregated in order to present a more

robust portrait of the extent to which children were benefiting from the SEEDS of Early

Literacy curriculum and individualized support.

Results

Children in classrooms incorporating the SEEDS of Early Literacy curriculum are demonstrating

improvements in their pre-literacy skills. When looking at the percentage of children ages 4+ who

were meeting targets for later reading success in English (scoring “At” or “Above” target level),

results showed that:

On average, by the end of the year more children were “At/Above” target level in all five pre-

literacy skill areas—in English—no matter what their primary language was.

o Letter Naming and Letter Sounds were the skill areas that had the highest percentage of

children who were “At/Above” target level by the end of the school year.

o An analysis of average scores on the Fall, Winter, and Spring benchmarks demonstrated

how much progress children made over the course of the school year. When assessed in

English, Spanish-speaking children on average started with lower scores than English-

speaking children, but by their last assessment they had increased their scores by a higher

amount than English-speaking children in Picture Naming and Rhyming, and nearly

equaled the English-speaking children’s increase in scores in Alliteration.

Figure 95: Reading Corps Classrooms: Children Ages 4+ Who Are At/Above Targets for Later Reading Success, in English (2012-2015)

Percentage of Children At/Above Targets

17.8%11.7% 11.4%

21.4%13.3%

2.7% 3.0% 4.6%7.9% 5.8%

33.5%26.4% 20.8%

42.8%

32.5%

8.1% 13.2%16.2%

25.0% 24.4%

49.7%

42.1%46.8%

60.6%

54.3%

19.2%

28.8% 31.6%

42.4% 44.4%

0%

20%

40%

60%

80%

100%

PictureNaming


LetterSounds

PictureNaming


LetterSounds

1st Benchmark (Oct.) 2nd Benchmark (Feb.) 3rd Benchmark (May)


Primarily English-Speaking Children



Figure 96: Children in Reading Corps Classrooms: Average Scores and Average Growth in Scores (Fall to Spring) – in English



Alliteration



N: English N= Oct.: Picture Naming (325), Rhyming (281), Alliteration (264), Letter Naming (318), Letter Sounds (308). N= Feb.: Picture Naming (355), Rhyming (330), Alliteration (317), Letter Naming (339), Letter Sounds (323). N= May: Picture Naming (336), Rhyming (316), Alliteration (295), Letter Naming (330), Letter Sounds (311). Spanish N= Oct.: Picture Naming (596), Rhyming (529), Alliteration (539), Letter Naming (592), Letter Sounds (565). N= Feb.: Picture Naming (679), Rhyming (635), Alliteration (612), Letter Naming (647), Letter Sounds (611). N= May: Picture Naming (657), Rhyming (618), Alliteration (605), Letter Naming (646), Letter Sounds (608).

0

2 Primarily English-Speaking Children


6.89.1

17.821.9

24.6

8.8

13.717.9

0

5

10

15

20

25

30


11.49.78.0

14.3

19.4

3.9

8.8

13.6

0

5

10

15

20

25


4.65.15.0

7.2

9.6

2.8

5.4

7.9

0

2

4

6

8

10

12


7.66.4

2.8

6.7

10.4

1.7

4.7

8.1

0

2

4

6

8

10

12


3.9 3.43.04.5

6.9

1.8

3.75.2

0

2

4

6

8




Children who received tailored interventions are nearly catching up with their peers. 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 needed to be done to help Spanish-speaking children increase their English

vocabulary (Picture Naming).

To this end, 2014-15 was the first year that the “Repeated Read Aloud” (RRA) strategy became the

main intervention for children needing extra help with their English vocabulary. It was used as a way to

increase vocabulary and fluency in English, which is done by teaching words in the context of a story.

The Big 5 early literacy skills are strategically spaced throughout the week so that there is a different

instructional focus each day, including the specific skills of Rhyming, Alliteration, Letter Naming, and

Letter Sounds. Consequently, the RRA intervention is considered one of the most effective strategies

in bringing about change in children’s pre-literacy skills. This tailored intervention is specifically geared

to dual language learners and the instruction is matched to children’s individual learning speeds. The

intervention provides tutors with a systematic way to discuss books as they re-read them with children

and encourages children to talk more each day. Literacy Tutors used the IGDIs and FAST assessments

to help them identify five children who were most challenged in picture naming (vocabulary), and

provided each of these children with this tailored intervention.

In these 2014-15 analyses of IGDIs and FAST assessments in English, the results are shown for children

who did not require interventions, and for children who received the RRA tailored interventions. The

first set of analyses show the percentage of children at each level of proficiency at each of the three

benchmarks (below target, near target, at/above target), and the second analysis shows the average

scores at each of the three benchmarks, and the average growth from Fall to Spring.

Overall results show that children who received tailored interventions showed remarkable

progress towards reaching greater proficiency in all pre-literacy skill areas, in English.

As would be expected, almost all children who were chosen to receive tailored interventions

had scored “Below” target at the beginning of the school year on the English-language

assessments. However, by the end of the school year, a majority of these children had moved

up into higher levels of proficiency (“Near,” or “At/Above” target).


Spanish-speaking children who had received tailored interventions.

o Not only did these Spanish-speaking children improve their skill levels, but the percentages

who were “Near,” or “At/Above” target by the end of the school year came quite close to

the percentages of their peers who had not required these tailored interventions. This was

particularly true in the areas of Alliteration, Letter Naming, and Letter Sounds.

o An analysis of average scores on the Fall, Winter, and Spring benchmarks showed that

when assessed in English, Spanish-speaking children who were selected to receive tailored

interventions started with lower scores than Spanish-speaking children who did not

require tailored interventions. But by their last assessment they had increased their scores

by a higher amount in Picture Naming and Rhyming.



This last result is especially encouraging, as it suggests that these tailored interventions are greatly

helping dual-language learners who are the most challenged with their English vocabulary skills.

These children are getting the tailored help they need to increase their vocabulary and bring them

up to a level where they can more fully benefit from the SEEDS of Early Literacy classroom

curriculum with the rest of their peers.

Figure 97: Impact of Tailored Interventions on Children’s Proficiency in Key Pre-Literacy Skills (2014-2015) – in English

Primarily English-Speaking Children Not Requiring Tailored Interventions

Primarily English-Speaking Children Who Received Tailored Interventions





30.1%9.1% 5.0%

55.3%46.1%

24.0%

65.9%

46.7%29.0%

58.8%

39.3%18.3%

78.8%

50.5%

24.2%

54.4%

60.0%

45.0%

28.7%

21.6%

28.1%

18.7%

25.7%

19.4%

12.7%

9.3%

14.4%

4.0%

13.3%

13.7%

15.5%

30.9%50.0%

16.0%32.4%

47.9%

15.4%27.6%

51.6%

28.4%

51.4%67.3%

17.2%36.2%

62.1%

0%

20%

40%

60%

80%

100%



94.1%

66.7%

29.4%

93.3%

58.8%

43.8%

100.0%

62.5%

31.3%

83.3%73.7%

50.0%

100.0%

72.2%

37.5%

5.9%33.3%

47.1%

6.7%

29.4%

18.8%

0.0%

37.5%

25.0%

16.7%

0.0%

22.2%

0.0%

22.2%

18.8%

0.0% 0.0%

23.5%

0.0%11.8%

37.5%

0.0% 0.0%

43.8%

0.0%

26.3% 27.8%

0.0%5.6%

43.8%

0%

20%

40%

60%

80%

100%







Primarily Spanish-Speaking Children Not Requiring Tailored Interventions

Primarily Spanish-Speaking Children Who Received Tailored Interventions





59.6%39.4%

22.2%

69.7%58.3%

36.7%

76.7%64.0%

48.3%

69.8%

51.0%32.0%

79.7%

61.3%

37.5%

33.7%51.0%

60.6%

22.4%26.0%

33.3%

17.8%27.0%

29.2%

16.3%

17.6%

18.0%

9.5%

12.9%

11.4%

6.7% 9.6% 17.2%7.9%

15.6%

30.0%

5.5% 9.0%22.5%

14.0%

31.4%

50.0%

10.8%25.8%

51.1%

0%

20%

40%

60%

80%

100%



94.4%72.6%

36.4%

89.5%71.1%

50.0%

80.0%71.8%

56.2%

78.3%

57.8%

33.8%

94.3%

67.1%

41.9%

5.6%26.2%

50.6%

10.5%23.7%

33.3%

12.3% 21.8%

20.5%

7.2%

20.5%

22.5%

2.9%

13.4%

13.5%

0.0% 1.2%13.0%

0.0%5.3%

16.7%

7.7% 6.4%23.3%

14.5%21.7%

43.8%

2.9%

19.5%

44.6%

0%

20%

40%

60%

80%

100%







Figure 98: Impact of Tailored Interventions: Average Scores and Average Growth in Scores (Fall to Spring)

Primarily Spanish-Speaking Children – in English



Alliteration




Did Not Require Tailored Interventions

Received Tailored Interventions

5.8

9.7

14.016.2

19.8

7.2

11.9

16.9

0

5

10

15

20

25


10.2 10.1

6.2

10.9

16.4

5.1

10.4

15.2

0

5

10

15

20


3.44.14.7

6.1

8.1

2.2

4.0

6.3

0

2

4

6

8

10


7.2 7.3

2.3

5.2

9.6

1.0

4.2

8.3

0

2

4

6

8

10

12


2.4 1.92.1

3.0

4.6

2.02.3

3.9

0

1

2

3

4

5




Santa Cruz Public Libraries

Toddler Time program

The Santa Cruz Public Libraries (SCPL) offer Toddler Time programs at six branches of the Santa Cruz

Public Libraries (Downtown, Live Oak, Boulder Creek, Scotts Valley, Aptos, and Branciforte). This program

is based on the previous “Family Place” program, and includes 60 minutes of moderately unstructured

play and activity time, including early literacy development with stories and songs, movement activities,

socialization activities, art activities, and parent discussion time. Occasionally community resource guests

participate in the program as well.

In September 2014 a new Toddler Time program began at the Branciforte branch of the SCPL,

with a regular group of families who come each week.

In 2014-15, SCPL provided a total of 241 Toddler Time programs to an estimated 4,946

families. Many families came to 2 or more Toddler Time programs each week.

In spring 2015, “Musical Me” visited several Toddler Times.

Brio Train Table

The Brio Train Table at Live Oak Branch was originally purchased with First 5 funding, and has been loved

by Live Oak children for almost a decade. In 2014-15 the train was restored with a new table top, track,

train cars, and accessories.

Raising A Reader

The SCPL schedules and hosts library visits for preschools that are participating in Raising A Reader (RAR).

In 2014-15, SCPL hosted a total of 14 Raising A Reader visits for 11 different preschools.

These RAR visits were attended by 179 parents and teachers and 268 children.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT 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

2014-15Total

Children 2,475 1,654 4,129


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 at least 277 sites (56 new and 221 existing)

Periodically, RAR 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.

“RAR has gotten our parents more involved. The red bag and books let them realize how simple and rewarding it can be to just be with your child and a book.”

“Books are the best connection between parents, school, students, and providers.”

“I heard a 10-month-old talk about ‘el rancho’ (the farm) after being read some RAR books.”

“I’m especially pleased to see that parents of infants in my program understand the importance of reading to very young children. I see a high level of engagement with books.”

“One family especially enjoyed the Read Aloud DVD and have noticed a big difference as they have been applying the techniques used.”

- Raising A Reader Provider Survey comments

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES 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* 2014-15

Total New Existing

Family Child Care Home 9 132 141

Preschool/Child Care Center 8 121 129

Total 17 253 270

Source: Raising A Reader Annual Progress Report, 2014-2015.

*Some sites may be visited more than once. Additionally, 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

Outcome Objective: Parents will spend time reading or sharing books with their child

Two surveys were conducted to help assess the effect of Raising A Reader on the amount of time

parents spent reading to their children, the interest children had in books, and the improvement in

children’s pre-literacy skills.

Provider Refresher Survey

Raising A Reader staff use the Provider Refresher Survey to indicate what replacement materials

they needed, and also to measure their perceptions of the impact of the RAR program at their sites.

Figure 99: Percentage of RAR Providers Who Noted These Key Pre-Literacy Findings (2014-15)

Source: Raising A Reader, Annual Progress Report, Provider Refresher Survey results, 2014-2015.

Parent Retrospective Survey

For the past several years, Raising A Reader has distributed a Parent Retrospective Survey to parents

participating in the program, asking them to self-report how often they performed certain activities

with their children before and after their participation in the RAR program. Each year a different

97.0% 98.0% 98.0%

0%

20%

40%

60%

80%

100%

Parents have increased theamount of time they read to their

child, after participating in RAR(N=151)

RAR has had an impact inencouraging parent-child

interactions(N=150)

RAR has had an impact onchildren's pre-literacy skills

(N=151)

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL - RAISING A READER


parent population and agency is given the survey. In April 2015 the Parent Retrospective Survey was

administered to parents at the Live Oak State Preschools literacy meetings.

Figure 100: Percentage of RAR Parents Who Practiced These Key Pre-Literacy Activities with Their Child (2014-15)

Source: Raising A Reader, Annual Progress Report, Parent Retrospective Survey results, 2014-2015.

N = 70.

55.0%44.0% 44.0%

83.0%74.0% 76.0% 76.0%

99.0%

0%

20%

40%

60%

80%

100%

Read or share bookswith their child 3-4

times a week

When sharing books, pointout pictures and talk about

them with their child

When sharing books,talk about new words

Share a book more thanonce with their child

Before participating in the RAR program After participating in the RAR program

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL - SUMMER PRE-K ACADEMY


Summer Pre-K Academy

Program Description

Pajaro Valley Unified School District (PVUSD)-Migrant Education implements a four-week summer

academy for children about to enter kindergarten at seven PVUSD elementary schools. The program

is designed to serve children from migrant families who have little or no preschool experience, in

the summer before they enter kindergarten. First 5 partners with PVUSD-Migrant Education to fund

100 additional children who do not qualify for Migrant Education. Although the Summer Pre-K

Academy serves children from both Monterey and Santa Cruz Counties, only the children from Santa

Cruz County enrolled due to First 5 funding are described in this report.

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. Using a culturally responsive program that

is aligned with the California Preschool Foundations, the program focuses on building on the home

language and bridging to English. The instruction is designed to accelerate the students’ kindergarten

readiness skills in order to narrow the achievement gap upon entering kindergarten.

Population Served

2014-2015

Children 68


Outcome Objective: Children will increase their recognition of letter sounds

Program Objectives

2014-2015

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.

85.2%

N=61

85.5%

N=55

Source: Migrant Education – Summer Pre-K Academy, Migrant Education Even Start (MEES) Pre-K Letter Sound Identification tool, 2015.

“This evidence based, culturally responsive program is aligned with the three California Preschool Foundations, with a focus on building on the home language and bridging to English. The instruction is designed to accelerate the students’ school readiness skills in order to narrow the achievement gap upon entering kindergarten, and provides many of the necessary tools that will help them reach their very first academic milestones.”

- Migrant Education, Annual Progress Report

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL - SUMMER PRE-K ACADEMY


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 12 new letter sounds after participating in this brief, yet focused program.

Figure 101: Summer Pre-K Academy Letter Sound Recognition Results (2015)

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, 2015. N: (All Students) N=61. (14 or more sessions Students) N=55.

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 18 letter sounds.

Figure 102: Percentage of Summer Pre-K Academy Students who Increased Their Letter Sound Recognition By At Least 5 Letter Sounds

Figure 103: 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 - 2015. 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, 2014=66, 2015=61. (14 or more sessions Students) 2009=65, 2010=31, 2011=67, 2012=72, 2013=95, 2014=53. 2015=55; no data for this population are available for 2007 and 2008.

85.2% 85.5%

0%20%40%60%80%

100%

All StudentsStudents who attended at least 14 sessions

6.6 6.4

18.7 18.3

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% 92.4% 85.2%

78.5% 80.6%92.5% 87.5% 87.4% 92.5%

85.5%

0%

50%

100%

2007 2008 2009 2010 2011 2012 2013 2014 2015

All Students Students who attended at least 14 sessions

14.2 13.3 13.1

9.4

16.315.7 14.7

16.8

12.113.7

10.8

16.0 16.415.0

17.5

12.0

0

4

8

12

16

20

2007 2008 2009 2010 2011 2012 2013 2014 2015

All Students Students who attended at least 14 sessions

FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT PARTNER PROFILES CHILDREN LEARNING AND READY FOR SCHOOL - TRANSITION TO KINDERGARTEN WORKSHOPS


Transition to Kindergarten

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 19 State and Federally funded Preschool sites throughout the

county.

Population Served

2014-2015


Source: First 5, Transition to Kindergarten Workshop Participant Data, 2014-2015.

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT CHILDREN LEARNING AND READY FOR SCHOOL - TRANSITION TO KINDERGARTEN WORKSHOPS


FIRST 5 SANTA CRUZ COUNTY 2014-2015 ANNUAL EVALUATION REPORT APPENDICES


APPENDICES

APPENDICES FIRST 5 SANTA CRUZ COUNTY 2014-2015 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–Hybrid Quality Continuum Framework and Tiers 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.

Acrimony Scale

The Acrimony Scale (Emery, 1982) is utilized by Triple P clients who participate in the Level 5

– Family Transitions program. This scale measures co-parental conflict between separated or

divorced parents. Scores are calculated as the average of all questions, and can range from 1

(low acrimony) to 4 (high acrimony).

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.33

Bayley Scales of Infant and Toddler Development, 3rd Edition

The Bayley Scales of Infant and Toddler Development is a standardized test that is used by the

Stanford Neurodevelopmental Foster Care Clinic (“SNDFCC”) 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 and Adolescent Needs and Strengths (CANS)

The Child and Adolescent Needs and Strengths (CANS) is used by the Side-by-Side program,

and is a document that organizes clinical information collected during a behavioral health

assessment in a consistent manner to improve communication among those involved in

planning care for a child or adolescent. The CANS is also used as a decision-support tool to

guide care planning, and to track changing strengths and needs over time. The following

areas are addressed in the instrument: life functioning, behavioral/emotional needs, risk

factors and behaviors, caregiver resources and needs, acculturation, transition to adulthood,

and child strengths. The CANS is an item-level tool; each domain is scored on a 4-point scale

(0-3), and there is no total score.

33

Brookes Publishing, Ages & Stages Questionnaires® (ASQ), http://www.brookespublishing.com/store/books/bricker-asq/, 2007.



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 is 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 is used by the Early Literacy Foundations, and assesses 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

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.

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 (CBQ) The Conflict Behavior Questionnaire (Robin & Foster, 1989) is 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 is completed by both

parents and adolescents, and discriminates between distressed and non-distressed families.

This 20-item measure contains both “positive” and “negative” statements regarding a child’s

social competence/conflictual behaviors. Clients answer each question by responding with

“true” or “false.” To obtain an overall measure of social competence, distressed responses

are given the value of 1, while non-distressed responses are given the 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) is 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 is completed by

parents in the program. Respondents indicate 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 families34. 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); one of these assessments was used by a First 5 partner:

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

34

California Department of Education. (2009). Introduction to Desired Results. Retrieved from http://www.cde.ca.gov/sp/cd/ci/desiredresults.asp



participating in their program in two domains, using a total of eight measures. In the Self and

Social Development domain, two measures are used to assess interactions and relationships

with adults. In the Language and Literacy Development domain, six measures are used to

assess language comprehension, communication skills, interest in literacy, and recognition of

symbols.

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.35 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.36

The ELLCO Pre-K is 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

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) is utilized

by participants in Levels 4 and 5 of the Triple P Program (this is only completed if the parent

has 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 who 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.37

35

Education Development Center, Inc., Center for Children and Families, Early Language and Literacy Classroom Observation Toolkit, 2002. 36

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.

37 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.



First 5 Apricot Database

On a biannual basis, funded partners are required to submit information on the program

participants who they directly served, and also on the status of their programs’ outcome

objectives. Client Characteristic Data (CCDs) and outcome data are gathered in one of three

ways, First 5’s Apricot database, customized Excel forms, or partner-specific data collection

forms.38

o First 5’s online database, originally called Santa Cruz County Services Unifying Network

(SCC SUN), was launched on January 1, 2004, and many partner agencies used this

database to record their clients’ data and other outcome data. The database is integrated,

meaning that information can be shared between agencies, if the appropriate consent is

obtained. Demographic information about these clients can then be extracted for analysis,

using unique IDs that maintained clients’ anonymity. In April 2015 this database was

upgraded to a more flexible and efficient database called Apricot, all previous data in SCC

SUN were migrated to this new database, and all current data are now being collected and

reported using Apricot.

o Partner agencies not using First 5’s Apricot database collect and submit demographic and

outcome data either using customized Excel forms developed by First 5, or in partner-

specific data collection forms.

In the course of evaluating CCDs, a “cleaning” process is performed. In this process, each

program’s data are standardized to use the same response sets, reviewed for accuracy and

completeness, and corrected wherever possible. These data are then migrated to a

customized statistical database that aggregates them and determines the unduplicated count

of individuals served by goal area, partner agency, and overall. Each client characteristic is

analyzed, with results that report 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 are determined in these ways:

For all partners except Triple P, children’s ages are calculated as of the first day of the funding cycle. This enables all children ages 0-5 to be included in the analyses, even if they turn six years old later in the fiscal year. Children not yet born by the first day of the funding cycle (i.e., born later in the funding cycle) are also included in the analyses and categorized as being under one year of age.

For Triple P children, their ages are calculated as of the date of their parent’s first assessments (“Pre-assessments”), or the date of their single program session. This date is chosen since many Triple P assessments require 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 is needed in order to identify whether or not it is appropriate to include those data in the analysis of that assessment.

38

In this report, client characteristic data (CCDs) collected via all approved methods—which are then combined and comprehensively analyzed—are collectively referred to as “First 5 CCD database.”



o The cities where clients live are 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

Formative Assessment System for Teachers (FAST)

Early childhood educators trained in the SEEDS of Early Literacy curriculum assess children’s

pre-literacy skills in three skill areas of Picture Naming, Rhyming, Alliteration (see Individual

Growth and Development Indicators), and also in the two skill areas of Letter Naming and

Letter Sounds, as measured by the Formative Assessment System for Teachers (FAST) literacy

assessment.

Along with the IGDIs assessment, the FAST literacy assessment is administered three times a

year and is used to help measure children’s progress in these key pre-literacy skill areas.

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.”39

Individual Growth and Development Indicators (IGDIs)

Early childhood educators in trained in the SEEDS of Early Literacy curriculum assess

children’s pre-literacy skills in the three areas measured by the Individual Growth and

Development Indicators (IGDIs) assessment tool (Picture Naming, Rhyming, Alliteration), and

also in the two skill areas of Letter Naming and Letter Sounds (see Formative Assessment

System for Teachers).

Individual Growth and Development Indicators (IGDIs) 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, IGDIs 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

39

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 is now directly noted by the teacher. Children noted as bilingual

(English/Spanish) are 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.

Only children ages 4 and 5 are included in these IGDIs analyses,40 in order to focus on

children who are at a similar developmental age just before entering kindergarten.

Additionally, the companion assessment given along with the IGDIs assessment (the

Formative Assessment System for Teachers) is not designed for children younger than 4,

which provides a framework for focusing on children ages 4 and 5. This focus on children

ages 4 and 5 began in 2013-14, and IGIDs and FAST data for all previous years have been

adjusted accordingly.

Migrant Education Even Start (MEES) Pre-K Letter Sound Identification

Children attending the PVUSD-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) is 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

40

To be included in these analyses, children had to be at least 4 years old as of October 1st of that fiscal year, which was the time of the 1

st

benchmark assessment.



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) is utilized by Level 3 of the Triple P

Program. It is a self-report measure of issues related to being a parent, and is 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) is utilized by clients in Levels 4

and 5 of the Triple P Program, as part of the general “Core” variant of program (this is only

completed if the parent has 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 is designed to be filled out by clients in both the Teen and Core variants, and the

appropriate items are used to calculate the factors and overall scores specific to that variant.

The impact of these modifications on the original Core version is 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 is 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) is utilized by

Level 5 Pathways of the Triple P Program (this is only completed if the parent has 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.

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.41

Triple P Satisfaction Survey

Multiple Sessions (Individual or Group)

The Multiple Sessions Satisfaction Survey is utilized by parents who complete

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 assess many different dimensions of

41

Children’s Research Center, Structured Decision Making Policy and Procedure Manual, 2006.



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. Participants also have the option of providing their email address if

they are interested in receiving the Triple P newsletter.

Single Sessions (Seminars & Workshops)

The Single Session Satisfaction Survey is utilized by parents who participate 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 fill out this short survey which

assesses if they felt that the Seminar or Workshop addressed their questions, whether they

are going to use any of the parenting strategies they learned, and if they are satisfied, overall,

with the Seminar or Workshop. Participants can also add any additional comments they have.

Late in fiscal year 2011-12 an additional question was added that asked participants how

they first heard about the program, and beginning 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 is used by the Stanford Neurodevelopmental Foster Care Clinic (“SNDFCC”), 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.

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