Economic Well-Being And Health: The Role Of Income Support Programs In Promoting Health And Advancing Health Equity.

People with low incomes have poorer health outcomes, including greater risk for disease and shorter lifespans. This pattern has the least favorable outcomes for those living in poverty but is present at every level of the income ladder. Income support programs that provide a social safety net for families-including the Earned Income Tax Credit and Temporary Assistance for Needy Families-can influence health by meeting families' basic needs and supporting participation in economic development. However, families face inequitable access to income support programs. States vary in whether they offer the Earned Income Tax Credit, and this can lead to unequal access and participation across groups. Critical challenges for policy makers are identifying barriers to access to and participation in income supports as well as developing strategies to increase equitable access to income supports. This article synthesizes evidence on income and health and its relevance to income supports.

A Trusted Source of Information: How Systematic Reviews Can Support User Decisions About Adopting Evidence-Based Programs.

BACKGROUND: Systematic reviews sponsored by federal departments or agencies play an increasingly important role in disseminating information about evidence-based programs and have become a trusted source of information for administrators and practitioners seeking evidence-based programs to implement. These users vary in their knowledge of evaluation methods and their ability to interpret systematic review findings. They must consider factors beyond program effectiveness when selecting an intervention, such as the relevance of the intervention to their target population, community context, and service delivery system; readiness for replication and scale-up; and the ability of their service delivery system or agency to implement the intervention. OBJECTIVE: To support user decisions about adopting evidence-based practices, this article discusses current systematic review practices and alternative approaches to synthesizing and presenting findings and providing information. METHOD: We reviewed the publicly available information on review methodology and findings for eight federally funded systematic reviews in the labor, education, early childhood, mental health/substance abuse, family support, and criminal justice topic areas. CONCLUSION: The eight federally sponsored evidence reviews we examined all provide information that can help users to interpret findings on evidence of effectiveness and to make adoption decisions. However, they are uneven in the amount, accessibility, and consistency of information they report. For all eight reviews, there is room for improvement in supporting users' adoption decisions through more detailed, accessible, and consistent information in these areas.

Supporting replication and scale-up of evidence-based home visiting programs: assessing the implementation knowledge base.

In recent years, researchers, policymakers, and practitioners have expressed a growing interest in the use of interventions with scientific evidence of effectiveness. Reproducing positive effects shown in research, however, requires more than simply adopting an evidence-based program. There is growing recognition across disciplines of the importance of implementation research to guide adoption, replication, and scale-up of evidence-based interventions. We evaluate the state of the knowledge base supporting replication and scale-up of evidence-based programs by reviewing information on implementation included in the research literature on 22 home visiting programs that have or are building an evidence base. We used the Interactive Systems Framework for Dissemination and Implementation to assess programs.

The effectiveness of early head start for 3-year-old children and their parents: lessons for policy and programs.

Early Head Start, a federal program begun in 1995 for low-income pregnant women and families with infants and toddlers, was evaluated through a randomized trial of 3,001 families in 17 programs. Interviews with primary caregivers, child assessments, and observations of parent-child interactions were completed when children were 3 years old. Caregivers were diverse in race-ethnicity, language, and other characteristics. Regression-adjusted impact analyses showed that 3-year-old program children performed better than did control children in cognitive and language development, displayed higher emotional engagement of the parent and sustained attention with play objects, and were lower in aggressive behavior. Compared with controls, Early Head Start parents were more emotionally supportive, provided more language and learning stimulation, read to their children more, and spanked less. The strongest and most numerous impacts were for programs that offered a mix of home-visiting and center-based services and that fully implemented the performance standards early.

Child care quality matters: how conclusions may vary with context.

Three studies examined associations between early child care and child outcomes among families different from those in the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network study. Results suggest that quality is an important influence on children's development and may be an important moderator of the amount of time in care. Thus, the generalizability of the NICHD findings may hinge on the context in which those results were obtained. These studies, conducted in three national contexts, with different regulatory climates, ranges of child care quality, and a diversity of family characteristics, suggest a need for more complete estimates of how both quality and quantity of child care may influence a range of young children's developmental outcomes.