• Type of Practice: Federally Qualified Health Center
• Location: Oakland, California
• Population Served: Low-income Asian American immigrant and refugee communities, specifically pregnant women as well as caregivers and children 0-2 years of age. Approximately 120 infants and their caregivers (mostly mothers) have been served by this program since its inception in March 2011.
  

• Group 8-10 infants of similar age, culture, and language backgrounds together for a group well child visit, allowing a pediatric clinician to spend up to two hours with a group of families.

• Schedule and implement a series of eight group well child visits over 18 months, based on Bright Futures guidelines.
• Utilize group visits to implement an interactive child development curriculum which educates caregivers on the following issues:
• Child development
• Nurturing and attachment
• Discipline
• Stress management
• Nutrition
• Safety
• Invite culturally and linguistically diverse community health workers from target communities to attend and co-facilitate group well child visits. These individuals can foster a culturally competent environment that enhances collaborative learning, care coordination, and caregiver support.
  
• Implement team-based, integrated care by supporting on-site case managers and licensed clinical social workers who screen for mental health, toxic stress, and domestic violence among participating families.
• Convene a project advisory board consisting of community and family members; host meetings 2-3 times per year.
• Seek feedback from family and community members by hosting focus groups that are facilitated by community leaders rather than project staff.
  
• Integrate evaluation components throughout the project to demonstrate project impact and secure funding and support for future endeavors.
• Explore multiple funding sources including the following:
• Healthy Tomorrows Partnership for Children Program
• Every Child Counts
• Universities
  
• Cultural advocacy organizations
• Title V funded programs
  

• Expanding the project beyond a demonstration to a widely adopted part of regular clinic operations was a challenge. The project utilized evaluation results to demonstrate its impact and enhance leadership buy-in for sustainability. Evaluation results included the following:
• Pre and post surveys were distributed to participating families. Results from the surveys demonstrated increased self-reported social support measures among families; increased utilization of positive discipline approaches; and increased nutritient intake among families and infants.
• Additional evaluation data indicate that 100% of participating families and children had up-to-date immunizations, 100% of mothers were screened for post-partum depression, and 100% of participating infants underwent structured developmental screening and were referred appropriately. 

• For more information, contact Joan Jeung, MD, MS, FAAP, Director, Empowering Mothers Initiative: joanjeung@gmail.com.
• For more information about the Healthy Tomorrows Partnership for Children Program (HTPCP), visit the HTPCP Web site.