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J Fam Theory Rev. 2019 Mar;11(1):112-126. doi: 10.1111/jftr.12302. Epub 2018 Nov 15.

Moving Beyond Program to Population Impact: Toward a Universal Early Childhood System of Care.

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Duke University, 2024 W. Main St., Box 90539, Durham, NC 27709-0539.


Families have clearly benefited from increased availability of evidence-based intervention, including home-visiting models and increased federal funding for programs benefiting parents and children. The goal of population-level impact on the health and well-being of infants and young children across entire communities, however, remains elusive. New approaches are needed to move beyond scaling of individual programs toward an integrated system of care in early childhood. To advance this goal, the current article provides a framework for developing an early childhood system of care that pairs a top-down goal for the alignment of services with a bottom-up goal of identifying and addressing needs of all families throughout early childhood. Further, we describe how universal newborn home visiting can be utilized to both support alignment of and family entry into an early childhood system of care with broad reach, high quality, and evidence of population impact for families and children.


Early intervention; home visiting; population health; system of care

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