Funded Projects

Grant Status: Active

Training Category: Healthy Tomorrows

Grant Title: Come Home New York: Helping Children with Homelessness Thrive

Project Director(s):

Katie Keown, MD, FAAP
Columbia University Irving Medical
The Trustees of Columbia University in the City of New York
New York City, NY
Phone: 212-305-6227
Email: mkk2147@cumc.columbia.edu

Problem:

The current rate of homelessness for families in New York City (NYC), is higher than in any other period in United States' history. Although children experiencing homelessness have higher rates of exposure to Adverse Childhood Experiences (ACEs) and developmental delays than do those with housing security, families in shelter are often focused more on survival than on preventive health needs while working toward stabilization. A lack of resources and exposure to multiple ACEs puts this population of children at risk for lifelong medical and developmental problems. Conversely undiagnosed developmental delay has been shown to increase risk of some ACEs (neglect, physical and sexual abuse). "Come Home New York: Helping Children with Homelessness Thrive" will build resilience and secure optimal health outcomes among children residing in NYC homeless shelters by improving detection and management of developmental delays, implementing universal ACE screening, facilitating therapeutic referrals for ACE exposure and developmental delays, and developing positive parenting support in NYC homeless shelters.

Goals and Objectives:

Project Goal: Improve the lifelong health and wellness outcomes of children residing in NYC homeless shelters Objective 1: Implement pediatrician-led trainings for shelter health center staff on early childhood development, behavior, positive parenting strategies, and ACEs Objective 2: Improve developmental surveillance, screening, and referral of developmental delays in shelter health centers Objective 3: Implement universal ACE screening, including connection to mental health resources and parenting support, for pediatric patients of shelter health centers and their parents Objective 4: Increase pediatric resident trainee exposure to homelessness as it affects the local pediatric population through service-learning opportunities.

Methodology:

Homeless shelter health center staff will be trained in early childhood development, positive parenting strategies, and ACEs through monthly train-the-trainer sessions, co-led by the Project Director and Columbia University pediatric resident trainees and grand rounds presentations from experts in the fields. Staff will be trained in ACE screening and referrals to health center and community-based therapeutic providers will be facilitated. Developmental surveillance, screening, and appropriate referrals to the NYC Early Intervention Program (EIP) or the Committee for Preschool Special Education (CPSE) will be facilitated by closed-loop referral methods. Parenting support through shelter-based positive parenting groups will be designed and developed in years 2-5 of the grant period.

Coordination:

The project will coordinate with Columbia University Community Pediatrics, Care For the Homeless (CFH) shelter health centers, Bronxworks, and the American Academy of Pediatrics (AAP) Chapter 3

Evaluation:

The project will engage in rigorous monitoring and evaluation activities to achieve project outcomes. An advisory committee, with membership from state AAP, local general and developmental-behavioral pediatricians, local mental health professionals, research scientists, social workers, social services organizations, and other key stakeholders will be established in order to steer the project and maintain best practice and fidelity to outcomes.