The assigned facility is a resource center that operates to assist families in need. Services offered include housing placement, homelessness prevention, securement of affordable childcare, after-school programs, and health education. The center has served the Mount Baker community for nearly three years and intends to continue partnering with public services to end the cycle of poverty and create brighter futures for those who need it most (Mercy Housing, 2021).
Our team conducted a windshield survey of the community served by the facility and determined there to be limited access to childcare in the area as well as minimal resources to promote healthy childhood development. With these findings, our team created an intervention aiming to positively affect early childhood development by meeting age-appropriate milestones. To meet this goal, we created developmental boxes for children ages 0-5 with basic care supplies, age-appropriate toys, and educational pamphlets for parents to be better equipped in caring for their young children.
Data from the windshield survey showed that 33.3% of residents in the area are unemployed, 33.2% of the population are people of color, and 10% live below the poverty line (Statistical Atlas, n.d.). According to the staff members crime rates have recently been increasing, making it unsafe for children. Families with children make up 27% of the population (Statistical Atlas, n.d.). Numerous families are struggling with finances and are at risk for falling below the poverty line. These statistics imply that parents may struggle to provide appropriate developmental resources for their children.
Homelessness and poverty have been proven to adversely affect children’s development as housing is a social determinant of health. Studies have shown that 37% of school-aged children who are from homeless families are falling below average in their schoolwork and 40% of those children have had to repeat grade levels (Murran & Brady, 2023). An association between poverty, children’s development and academic performance is evident as early as two years old. School readiness upon entering kindergarten sets the trajectory for future success (Engle & Black, 2008). Our group assembled developmental boxes targeting children ranging from newborn to 5 years old, including hygiene necessities, clothing, and age-appropriate toys. Due to poverty and homelessness, children in this age group often do not have access to developmental activities to aid in meeting their milestones.
According to Erikson’s theory of Development, children in the age group of 0-18 months are expected to have a secure environment provided by their caregiver, in which they can develop in the stage of trust vs. mistrust. Children are expected to develop the skill of trust and hope in their primary caregivers. However, those who experience adverse childhood events such as unstable income, housing, clothing, and food resources are at a greater risk of developing mistrust and having developmental delays.
Children in the age group of 18 months to 3 years old are expected to have a caregiver that promotes self-sufficiency while maintaining a secure environment. This helps the child develop a sense of autonomy. However, children from homeless and low-income families may not fully meet this stage due to lack of resources and a secure environment. As a result of lacking a safe home environment to independently explore, clothes to practice dressing themselves, food to begin feeding themselves, toys to independently play with, and access to toilet training, these children may not be equipped with a sense of will, confidence, or autonomy to navigate the world on their own successfully, and may instead experience shame and doubt.
Children in the age group of 3 to 5 years old are expected to have a caregiver that encourages, supports, and guides their own initiatives and interests (Orenstein & Lewis, 2023). The purpose of the developmental boxes is to promote proper development for children within this population, who often lack the necessary resources for this development to progress. Specifically, play is a universal childhood activity that fosters development. Play promotes executive function skills by encouraging children to take on cognitive demands, pursue goals, create problems to solve, make choices, and engage in personal interests (Doebel & Lillard, 2023).
The developmental boxes that our group assembled include an educational pamphlet focusing on breastfeeding, PURPLE crying, and common childhood illnesses, as well as a map composed of local resources for families. PURPLE crying involves peaks of unexplained, long-lasting crying, which is resistant to soothing (Reese et al., 2014). The population in this area is at a high risk for knowledge deficit due to lack of resources and increased homelessness (Bridget & Oudshoorn, 2019). By providing the pamphlet and resource map in the developmental boxes, parents are receiving education with fundamental information and locations of resources to promote their child’s health and well-being. Common childhood illnesses include the common cold, ear infections, influenza, RSV, and strep throat (Wakeforest Pediatrics Associates, 2022). Additionally, parents may not be aware of specific illnesses their child may have if they are displaying certain symptoms or which symptoms require emergency intervention. The pamphlet also listed symptoms that would require seeking emergency care including coughing up thick, green-yellow phlegm or blood, vomiting, difficulty breathing, severely drowsy, and presenting with blue skin (Raising Children, 2023). Homeless and low-income families often face barriers to accessing health care including transportation, costs, complex systems, communication barriers and not knowing where to go (Bridget & Oudshoorn, 2019). This information is extremely important to supply families with the knowledge they need to support their child’s health.
The group set two SMART goals for the project- the first being 75% of families receiving the developmental boxes would report satisfaction with box contents by the end of the quarter. The second project goal was a reduction in screen time from children engaging with the developmental boxes by the end of the quarter. Results from the survey showed 5-10 children engaged with the developmental boxes. Staff and parents reported high satisfaction with the boxes with a reduction in screen time. The facility plans to continue using the developmental boxes following this quarter and rated sustainability to be 4/5. The additional materials provided including the educational pamphlet and resource map were also rated 4/5 as informational and educational. With this data, we conclude that both project goals have been successfully met.
The facility exhibited a need for resources related to early childhood development. Our team created an intervention called “Developmental Boxes,” with the aim to decrease screen time in children and provide parents with educational materials to properly care for their young children. Multiple limitations presented themselves during the project- the first being the flooding of the original facility which caused displacement of staff and temporary closure of the site. This prohibited us from serving the originally assigned facility and neighboring community with our intervention. Another limitation that arose was the limited amount of feedback received from staff onsite. This may be due to the displacement of the original staff, and addition of new staff members to the project. Since these staff were introduced late in the quarter, they were unaware of the project idea. Although these limitations made the project challenging, results showed that both project goals were met. The facility reported high ratings for sustainability and plans to continue utilizing the Developmental Boxes once the quarter ends through public donations and federal funding. This project will continue to support future families and young children in their growth and development.
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Ryabinina, Karina; Kelly, Lauren; Bankey, Marissa; Medeiros, Kaila; and Schultz, Sammy, "Developmental Boxes" (2023). Nursing Leadership in Community Engagement Projects. 30.
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