Vanderburgh County’s Pre to 3 program aims to reduce infant mortality by offering long-term support for families, providing free home visits for families from pregnancy until the baby turns three years old. For many families, it’s a lifeline to support services, education and resources and a connection to someone who cares. Last year, the Foundation for Better Health, a health department partner, utilized Early Years Initiative grant funding to expand the Pre to 3 program to more families in need.
The team currently serves 300 clients in the community, pairing each family with a dedicated community health worker. For families that do not speak English as a first language, the goal is to match with a community health worker that speaks the family’s native language.
“That's a key area we all feel passionate about. Everybody should receive services in the language that they're comfortable with. We hold that model very close to our hearts.”
Families who need additional support have access to a client advocate to address social determinants of health needs, as well as a nurse to provide clinical services in the home.
“Our program is very well respected within the community, and we have a lot of community partners,” Herr shares, highlighting strong partnerships with local birthing centers, Black Nurses of Evansville and other like-minded organizations. “We’re very integrated into the community, and we’re all really focused on improving our infant mortality rates.”
As the Pre to 3 program, created by the Vanderburgh County Health Department, has grown and flourished over the past six years, the team saw an opportunity to share their experience and knowledge with neighboring counties. Last year, foundation staff worked with the Dubois County Health Department to implement Pre to 3, providing foundational training and ongoing support. “The Dubois County team provides the services directly in their community,” said Charissa Schuetz, Vanderburgh County Health Department Director of Accreditation and Public Health Expansion, “and we’re able to support by providing data infrastructure, charting documentation and billing and reporting services, allowing their team to focus on providing care.”
In partnership with Purdue University, the Pre to 3 team is working on several research-based journal articles focusing on return on investment, the utilization of community health workers, maternal child health outcomes, infant mortality and other program measures. All families complete a Healthy Families Parenting Inventory upon joining the program and every six months after. The evidence-based tool provides a rich data source for measuring program effectiveness and outcomes, with the first analysis set for early 2025.
The Pre to 3 program can also be tailored to specific community needs. “We’ve added the Hope at Home curriculum, which focuses on substance use,” said Ashly Holt, Pre to 3 Program Manager. “We utilize that curriculum for families that have any history of substance use and it’s allowed our team members to address that difficult conversation in a sensitive and trauma-informed way.”
Holt shares the story of one mom who started Pre to 3 early in her pregnancy, when she was in an active substance use phase. “She started recovery during her time in the program, and even now that her child is two years old she often tells us that the support from Pre to 3 is one of the key things that’s kept her from relapsing,” Holt said. “She’s tried other programs in the past, but the structure of our support, the trauma-informed care, the evidence-based approach is something that has really stuck. She’s been able to hold on and make those changes in her life.”
Early literacy is another key component of the Pre to 3 program. Client advocates partner with local libraries to ensure every family receives a library card, helping to remove barriers such as transportation or proof of residency and showing families how to utilize the library’s online and in-person resources. Families track the number of books read and are rewarded with prizes such as clothing store vouchers, stickers, cups and t-shirts for reaching goals and milestones.
It’s bittersweet when families age out of the Pre to 3 program, but the team ensures each family is set up for success after graduation. “We definitely make a plan so that as the graduation date approaches, we make sure the family is connected with child care or preschool,” Herr said. “We’ve also partnered with different organizations to offer supplemental home visits, and lots of our families stay in touch and send us updates. The goal of the program is really to build up their support network, to strengthen the family and build that self-reliance.”
Lakeisha Roach, Pre to 3 Program Intake Coordinator and Team Lead, recently celebrated her 16th graduating family and highlighted one mom that holds a special place in her heart. “This mom had been through a lot of trauma in her life from a very young age, was a single mom of two children, and decided that she wanted to break that stigma,” Roach said, sharing that the mom graduated from the University of Louisville with a bachelor’s degree in social work, got her first job as a social worker, and is going back to school to earn her master’s degree. “I’m just really, really proud of her and all she’s accomplished. She was not an affectionate mom when she started the program and would rarely hug or kiss her daughter. We’ve come such a long way with her showing affection and opening up and letting people in. I’ve seen her blossom in a big way since joining the program.”
Looking ahead, the team hopes to further expand services throughout Vanderburgh County and build capacity to support families currently on a waitlist; expansion to other counties is a possibility too, pending resources and funding. “There’s a million success stories coming out of this program,” Herr said. “I couldn’t be prouder of our team, this program and the families in it who are working so hard to improve the lives of their kids.”
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Wow, they are truly changing lives!