California Border Healthy Start (CBHS+)
Healthy Start: Pregnancy and Early Childhood Support
Healthy Start offers free and confidential parenting education and support for families in Central and East San Diego. Health educators (“patient navigators”) who are highly trained in perinatal support and case management provide home-based visits for families from the time they are pregnant until their child is 2 years old. Our goals are to empower parents as their children’s best teachers and advocates, stimulate and support early child development through healthy and nurturing parent-child interactions, improve women’s health before, during, after and between pregnancies, and strengthen family resilience.
Many additional supports are provided including doula support during labor, lactation support, car seat safety classes, programs for fathers, HEAL (mental health wellness) classes, and access to special events. In addition, the Healthy Start Community Action Network (CAN) is an array of partners across San Diego working to improve healthy pregnancies, safe and empowering births, and nurturing parenting for every child in San Diego. The CAN has active working groups that meet monthly.
About Healthy Start
National Healthy Start Goals:
- Improve the health of women before, during, and after pregnancy
- Promote quality improvement in perinatal services, preventive health and health workforce
- Strengthen family resilience
- Achieve collective impact
- Increase accountability through quality improvement and performance monitoring & evaluation
Since 2007, PCI’s California Border Healthy Start project has increased early entry into prenatal care by 24% and improved mental health by 40-60% among pregnant women and mothers of children under two.
The project provides 500 pregnant women each year in the targeted zip codes with free home visitation, non-medical case management and support to ensure a healthy pregnancy and delivery, as well as ongoing care and parenting education until the child is two years of age.
Two service pathways exist for women of different risk levels and interests:
(1) monthly home visiting using the evidence-based Parents As Teachers (PAT) home visiting model, and (2) group-based support and care coordination through PCI’s CARE Group empowerment model.
Beginning in the prenatal period, each family receives tailored monthly home visits by an experienced Patient Navigator that includes education and skill building in child development and parenting aligned to the Parents as Teachers (PAT) curriculum. The PAT model ensures early detection of developmental delays and health issues; helps prevent child abuse and neglect; and increases children’s school readiness. Families receive comprehensive family assessments, child development screenings using the Ages and Stages tool, regular group connections and at least 12 personal visits per year.
Women are screened regularly for depression in both the prenatal and postpartum period using the Edinburgh Depression Screening Tool (PHQ-9), and referred to PCI’s Health Education and Action for Living (HEAL) mental health support and depression prevention groups or additional mental health services as needed.
The program also engages fathers and partners of participants through its Fatherhood program, which works with fathers to better support the health of their families, improve their own health and build healthy, resilient families. Women without partners or family support are also provided with a PCI-trained volunteer doula to assist them in preparing for birth, support them in labor and delivery, and to visit them in the home once they return from the hospital.
Consistent with its focus on supporting women and families across their life course, CBHS+ works to improve the health of women and their families beyond their childbearing years, and in all aspects of their lives. All participants develop reproductive life plans and, through the CARE group model, women receive individualized support to pursue a goal of their choice and become part of a supportive community of women on a path to empowerment. With facilitation from a trained Patient Navigator, groups of 10-15 women meet regularly to strengthen their resilience through improved life skills, mental health and economic empowerment.
Through both home visiting and CARE groups, PCI’s experienced Patient Navigators work closely with partner clinics to ensure each participant has a medical home, and to connect participants to an array of enabling and supportive health and social services including pregnancy/childbirth education activities, parenting skill building/education, breastfeeding education, counseling and support, transportation, translation, child care, nutrition education and counseling services, male support services, housing assistance, job preparedness training, legal/immigration and any other services needed.
“I would like to thank California Healthy Start Project for all the benefits I have received. My Patient Navigator visited me since I was 25 weeks pregnant; the visits were done at my work and monthly until I delivered my baby. She referred me to the doula Program which was a great help, she assisted me at the hospital with translation and helped me to know that I was not alone. My PN explained to me about the importance of immunizations and child check-ups. I definitely would recommend this Program to other women like me.”
Maribel and Brandon, CHBS+ Participant