This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, will assess the feasibility and acceptability of an intervention designed to align medical, public health, and social service systems to support integrated, culturally responsive early childhood care for Latino and farmworker families residing in California’s northern coast in order to prevent and manage early childhood developmental delays and disabilities. The intervention is designed to disrupt systemic racism in early childhood systems that limits access to care for minority communities—including language inaccessibility, fragmented referrals, disinvestment in clinical infrastructure, and institutional distrust—by redesigning access points around trusted community infrastructure.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, will pilot test a school-embedded Point-of-Service (POS) coordination system designed to align medical care, public health, and social service systems for children and families in the historically Black Homewood neighborhood of Pittsburgh. The intervention seeks to dismantle systemic racism that manifests as fragmented systems with administrative burdens that routinely delay or deny care for Black families.

Building off of the Aligning Delivery and Financing Systems to Prevent Adverse Child Experiences in St. Louis study, Washington University in St. Louis will study the impact of systemic racism on child mental healthcare and mental health equity. African-American families are disproportionately affected by barriers to preventative services leading to worsening socio-emotional, mental health, and physical health outcomes. This is especially true in St. Louis, Missouri, where a profound history of oppression, systemic racism, and mistrust have exacerbated mental health challenges.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, evaluates the feasibility of the Youth Wellness Hub as a hyper-local community governance model for integrating delivery and financing systems for youth behavioral health and wellness services. The Youth Wellness Hub combines three social policy tools that are separately promising or well-supported in the research literature: community governance; public health education campaigns; and service network coordination through fiscal blending.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, tests the feasibility of an integrated system of medical, social and public health programming designed to improve outcomes for youth experiencing homelessness in Hennepin County, Minnesota. The study organizes community-engaged consensus building sessions with stakeholders from medical, social and public health systems and with youth experiencing homelessness in order to co-create strategies for system alignment, including multi-sector data integration, shared clinical practice guidelines, and co-location of health and social services for youth experiencing homelessness.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, evaluates the effectiveness of California’s CalAIM Medicaid Waiver program in integrating social service and public health organizations into Medicaid coordinated systems of care for individuals with complex health and social needs. CalAIM is designed to dismantle forms of structural racism by investing nearly $2 Billion in helping Medicaid health plans and medical providers forge stronger alliances with local social service organizations and public health agencies in addressing the complex health and social needs of Medicaid beneficiaries, including paying for nonmedical services needed by these beneficiaries.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, evaluates the feasibility of a modified Church-based home visiting program that aims to align health and social services for households with young children and dismantle forms of structural racism faced by these households. The program to be modified and tested is delivered by Shiloh Baptist Church in Trenton New Jersey, a predominantly Black congregation, with the goal of reducing adverse childhood experiences (ACES) and promoting positive childhood experiences within historically marginalized families and communities.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, evaluates the feasibility of a multi-sector “Functional Zero” approach to reducing homelessness among fathers in Atlanta, with a focus on Black fathers who are disproportionately represented among homeless populations. The study builds from an existing multi-sector coalition of leaders from medical, social and public health sectors who have formed Fathers Matter ATL to address the unmet health and social needs of homeless fathers, including forms of structural racism that limit the availability of housing options for homeless men with dependent children.

This study tests the feasibility of a multi-sector tribally-operated data system and dashboard for documenting health and social service needs and service referrals among youth members of the Coeur d-Alene tribe. The integrated data system is designed to achieve data sovereignty and improve timeliness and coordination in the delivery of health and social services for the tribal youth population, thereby dismantling forms of structural racism and inequity created by reliance on fragmented non-tribal service delivery and financing systems.

This study evaluates the effectiveness of an aligned service delivery and financing model designed to improve maternal and infant health by helping Medicaid-eligible persons receive access to healthy foods during pregnancy. The Nourishing Tomorrow (formerly Nourishing Beginnings) program uses integrated data, screening and referral systems combined with community health worker support to link people in need with healthy food delivery from a local food bank or with direct cash assistance for food purchases.

This study evaluates the effectiveness of multi-sector Partnerships for Early Childhood Development (PECD) in maintaining social needs screening, referral, and service delivery for children during the COVID-19 pandemic in New York City. PECD is an initiative that provides funding and guidance to help pediatric primary care practices partner with community-based social service organizations to address the social needs of children and families.

This study tests the effectiveness of multi-sector financing and delivery strategies in expanding the reach and impact of the Nurse-Family Partnership (NFP) program across the U.S. Despite rigorous evidence of its ability to improve health and social outcomes for low-income pregnant women and their children, the NFP home visiting program currently reaches only a small proportion of the communities and families who could benefit from it.

This study tests an innovative model for preventing child maltreatment and adverse child experiences (ACEs) by aligning health and social services for vulnerable families in St. Louis. The Parents and Children Together - St. Louis (PACT-STL) initiative braids together services and funding streams from multiple sectors to assist families with children who are referred to child protective services (CPS) for first-time and low-severity problems.

The prolonged activation of stress response systems among children responding to adversity such as homelessness, hunger, or neglect, is a predictor of poor health and continued poverty among low-income families. To study the health and economic impacts and systems implications of integrated services provided by the Pennsylvania Department of Human Services and Drexel University’s Center for Hunger-Free Communities, the principal investigators are evaluating the Building Wealth and Health Network (The Network) intervention, designed to reduce health inequities by aligning Medicaid coverage for behavioral health services and Temporary Assistance for Needy Families (TANF) education and training services.

Declines in academic performance often precede declines in health and health behaviors, particularly among minority youth living in economically distressed communities. The social and economic burdens imposed on communities with high rates of mental illness could be alleviated if patients were diagnosed and treated in adolescence rather than adulthood. Many adolescents with behavioral health needs fail to seek early treatment due to lack of access to care, finances, or knowledge of available resources.

Children affected by the opioid epidemic need a complex array of services and supports to safeguard their health and wellbeing, including child protective services, legal representation, educational services, comprehensive physical and mental health care, and often foster care placement coupled with family reunification strategies. Timely access to these services is especially difficult in rural areas. A research team led by Ohio State University will examine strategies that use regional, multi-sector governing boards to help organizations work together in coordinating services for children and families in rural areas.

Involvement with the criminal justice system increases markedly during the transition from youth to adulthood in the United States. Providing targeted services and supports to vulnerable emerging adults during this transition may be an effective way of reducing the conditions and behaviors that lead to incarceration and its adverse health effects. The research team led by Texas A&M University uses a randomized trial to test the effectiveness of the Transformative Justice (TJ) program in reducing criminal justice recidivism and improving health outcomes by coordinating health and social services for justice-involved young adults.