First 5 Santa Cruz County 2010-11 Annual Evaluation Report

FIRST 5 SANTA CRUZ COUNTY 

ANNUAL EVALUATION REPORT 

July 1, 2010 - June 30, 2011 

October 2011 

OUR MISSION: 

OUR VISION: 

All Santa Cruz County Children 

enter school ready to achieve 

to their greatest potential. 

To help children succeed in school and in life, 

First 5 Santa Cruz County invests in health, early 

learning, and family support to promote optimal 

development of Santa Cruz County children.

Acknowledgements 

First 5 Santa Cruz County would like to acknowledge Applied Survey Research (ASR) for their support 

and assistance with the evaluation and this report. First 5 Santa Cruz County also thanks Nicole 

Young, of Optimal Solutions Consulting, for the close collaboration in crafting the procedures 

necessary to successfully evaluate the Triple P program. 

First 5 Santa Cruz County would also like to thank the staff and participants of the funded partner 

agencies whose commitment to data collection has facilitated the gathering of the robust data 

included in this report. 

First 5 Santa Cruz County Applied Survey Research Optimal Solutions Consulting 

Susan True 

Stephanie Bluford 

Vicki Boriack 

Angela Cline 

Barbara Dana 

Irene Freiberg 

Holly Maclure 

Alicia Zenteno 

Susan Brutschy 

Lisa Colvig‐Amir 

Javier Salcedo 

Kim Carpenter 

Beth Jaworski 

Kathryn Branscomb 

Laurie Jacobs 

Melissa Mollard 

Te Guerra 

Nicole M. Young

FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT TABLE OF CONTENTS 

Table of Contents 

Executive Summary ........................................................................ 1 

Overall Well‐Being of Children in the County ............................................................................ 4 

A Profile of First 5 Participants ................................................................................................. 5 

Healthy Children ...................................................................................................................... 7 

Strong Families ........................................................................................................................ 9 

Children Learning and Ready for School ................................................................................. 11 

Service Integration & Community Strengthening .................................................................... 13 

Summary ............................................................................................................................... 14 

Part 1: Strategic Framework Results ............................................ 17 

Overview of the Strategic Framework .................................................................................... 19 

Overall Well-Being of Children in the County ................................................................... 21 

A Profile of Santa Cruz County’s Youngest Children ................................................................ 21 

County‐Wide Trends in Indicators of Child and Family Well‐Being .......................................... 22 

Profile of Participants ......................................................................................................... 29 

Number of Children and Families Served ................................................................................ 29 

Increase Services into Communities with the Highest Needs .................................................. 31 

Healthy Children ................................................................................................................ 37 

Increase Insurance Coverage .................................................................................................. 37 

Increase Use of Medical/Dental Homes .................................................................................. 41 

Increase Use of Preventive Health Services ............................................................................ 42 

Strong Families .................................................................................................................. 45 

Decrease Child Abuse and Neglect ......................................................................................... 45 

Improve Parent and Caregiver Practices that Support Children’s Social and Emotional 

Development ......................................................................................................................... 48 

Children Learning and Ready for School ........................................................................... 55 

Improve School Readiness Outcomes ..................................................................................... 55 

Increase Use of Quality Early Child Care Practices ................................................................... 56 

Increase Early Literacy Skills of Children ................................................................................. 64 

Increase Use of Kindergarten Transition Practices .................................................................. 66 


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TABLE OF CONTENTS FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT 

Service Integration & Community Strengthening ................................................................ 69 

First 5 Service Integration ...................................................................................................... 69 

First 5 Fiscal Status and Sustainability .................................................................................... 71 

Community Strengthening ..................................................................................................... 74 

Part 2: Partner Profiles ................................................................ 77 

Healthy Kids Initiative ............................................................................................................ 80 

Families Together .................................................................................................................. 85 

Triple P – Positive Parenting Program .................................................................................... 91 

Side‐by‐Side ......................................................................................................................... 129 

La Manzana Community Resources ...................................................................................... 132 

Mountain Community Resources ......................................................................................... 139 

Early Literacy Foundations (ELF) ........................................................................................... 141 

Raising A Reader .................................................................................................................. 153 

Starlight Infant/Toddler Program ......................................................................................... 155 

School Readiness � Steps to Success .................................................................................... 158 

Child Snapshot ...................................................................................................................................... 158 

Literacy Continuing Education Workshops ........................................................................................... 161 

Migrant Education – Summer Pre‐K Academy ..................................................................................... 163 

Migrant Education School Readiness Program .................................................................................... 165 

Pajaro Valley Unified School District (PVUSD) Parent Conference ....................................................... 168 

Transition to School Workshops ........................................................................................................... 169 

Appendices ................................................................................ 171 

Appendix I: First 5 Santa Cruz County Strategic Framework .................................................. 173 

Appendix II: Measurement Tools ......................................................................................... 175 

ii FIRST 5 SANTA CRUZ COUNTY

FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT TABLE OF FIGURES 

Table of Figures 

Figure 1: Number of County Children ages 0‐5 .......................................................................................................... 21 

Figure 2: Ethnicity of County Children ages 0‐5 (2011) ............................................................................................ 21 

Figure 3: English Language Proficiency of County Kindergarteners (2010) ............................................................... 21 

Figure 4: Unemployment Rate ................................................................................................................................... 22 

Figure 5: County Enrollment in CalWORKS ................................................................................................................ 23 

Figure 6: County Enrollment in Public Assistance Nutritional Programs .................................................................... 23 

Figure 7: County Enrollment in Medi‐Cal ................................................................................................................... 24 

Figure 8: County Enrollment in Healthy Families ....................................................................................................... 24 

Figure 9: County Enrollment in Healthy Kids .............................................................................................................. 24 

Figure 10: Percentage of Mothers in Santa Cruz County Receiving Prenatal Care in the First Trimester, by Age ....... 25 

Figure 11: Percentage of Mothers in Santa Cruz County Receiving Prenatal Care in the First Trimester, by 

Payment Method ........................................................................................................................................ 25 

Figure 12: Percentage of Births to Teen Mothers (Ages 19 and under) ....................................................................... 26 

Figure 13: Teen Birth Rate (per 1,000, Ages 15‐19) ..................................................................................................... 26 

Figure 14: Percentage of Births in Santa Cruz County Paid by Medi‐Cal ...................................................................... 27 

Figure 15: Percentage of Children in Preschool Programs and Kindergarten Who Have Individualized Education 

or Family Service Plans (IEP/IFSP) ............................................................................................................... 28 

Figure 16: Total Unduplicated Children and Parents Served, by Goal Area and Age ................................................... 29 

Figure 17: Percentage of Children 0‐5 in Santa Cruz County Served by First 5 ............................................................ 30 

Figure 18: Demographics of Children Participating in First 5 Programs, by Year ......................................................... 31 

Figure 19: Annual Family Income of Parents Participating in First 5 Programs, 2010‐11............................................. 32 

Figure 20: Percentage of First 5 Families with Income below Poverty and Self‐Sufficiency Thresholds, by Year ........ 32 

Figure 21: Levels of Children’s Vulnerability in Santa Cruz County, by ZIP code .......................................................... 33 

Figure 22: Distribution of Children Who Received Services (2010‐11), by ZIP Code .................................................... 34 

Figure 23: Number of Children Who Received Services, by ZIP Code .......................................................................... 34 

Figure 24: Early Childhood Educators Served by First 5, by Type ................................................................................. 35 

Figure 25: Percentage of Children ages 0‐5 in Santa Cruz County Estimated to be Insured ........................................ 37 

Figure 26: Children (Ages 0‐5) Newly Enrolled by HCOC in Healthy Kids, Healthy Families and Medi‐Cal 

insurance plans ........................................................................................................................................... 38 

Figure 27: Number of Children (Ages 0‐5) in Santa Cruz County Re‐Enrolled in Publicly‐Funded Health 

Insurance Programs, by Year ....................................................................................................................... 39 

Figure 28: Newborn Enrollment Project Statistics, 2010‐11 ........................................................................................ 40 

Figure 29: Percentage of Children in the County Enrolled in Healthy Kids (Ages 2‐6) Who Had Access to a 

Primary Care Practitioner ............................................................................................................................ 41 

Figure 30: Percentage of Parents Reporting their Children Utilized Health Care Prior to Renewal in an 

Insurance Program ...................................................................................................................................... 41 

Figure 31: Percentage of Children in the County Enrolled in Healthy Kids Who Had a Dental Visit in the 

Past Year ..................................................................................................................................................... 42 

Figure 32: Percentage of Children (Ages 3‐6) in the County Enrolled in Healthy Kids Who Received a 

Well‐Child Visit ............................................................................................................................................ 42 

Figure 33: Visits to Emergency Department in the Past Year, per 1,000 Member Year (Ages 1‐9) ............................. 43 

Figure 34: Number of Emergency Department Visits (Infants Less Than One Year Old).............................................. 43 

Figure 35: Rate of Substantiated Allegations of Child Maltreatment in Santa Cruz County and California 

(per 1,000) ................................................................................................................................................... 45 

Figure 36: Change in Families Together Participant’s Risk Levels Over Time, 2007 ‐ 2011 ......................................... 46 


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TABLE OF FIGURES FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT 

Figure 37: Number of Families Together Families who had Substantated Allegations of Abuse within 6 Months 

after Completing the Program .................................................................................................................... 47 

Figure 38: Participants with a Substantiated Allegation of Child Maltreatment Occurring Up to 6 Months after 

Program Entry ............................................................................................................................................. 48 

Figure 39: The 17 Core Parenting Skills Promoted by Triple P ..................................................................................... 49 

Figure 40: Parents’ Use of Positive Discipline Styles .................................................................................................... 51 

Figure 41: Level of Parental Problems with Child Behavior ......................................................................................... 52 

Figure 42: Levels of Parenting Difficulty Six Months After Triple P Services ................................................................ 53 

Figure 43: Percentage of 3 rd Grade Students in the County At / Above Grade Level In English/Language Arts .......... 55 

Figure 44: Number of Early Childhood Educators Who Have Completed SEEDS trainings .......................................... 58 

Figure 45: Number of SEEDS Trained Early Childhood Educators in Licensed Programs, by type of classroom 

(2007‐2011) ................................................................................................................................................. 59 

Figure 46: Primary Language of SEEDS Trained Early Childhood Educators in Licensed Programs (2007‐2011) ......... 59 

Figure 47: Educational Attainment of SEEDS Trained Early Childhood Educators in Licensed Programs 

(2007‐2011) ................................................................................................................................................. 59 

Figure 48: Number of Children Participating in Raising A Reader ................................................................................ 60 

Figure 49: Classroom Support for Language and Literacy (2010‐2011) ...................................................................... 61 

Figure 50: Key Language and Literacy Questions (2007‐2011).................................................................................... 62 

Figure 51: Average FCCERS Scores at Pre and Post Assessment on Literacy‐Related Items (2009‐2011) .................... 63 

Figure 52: Average ITERS Scores at Pre and Post Assessment on Literacy‐Related Items (2009‐2011) ...................... 63 

Figure 53: Percentage of Children Scoring “At” or “Above” the Target Level in Three Pre‐Literacy Skill Areas, by 

Primary Language, 2010‐2011..................................................................................................................... 64 

Figure 54: Percentage of Children Meeting Targets for Later Reading Success, by Primary Language ........................ 65 

Figure 55: Changes in Students’ Letter Sound Recognition Skills After Participation in Migrant Education Pre‐ 

School Programs ......................................................................................................................................... 66 

Figure 56: Number of Child Snapshot Forms Collected from Participating Preschool Programs ................................. 67 

Figure 57: Students’ Average School Readiness Levels Across the Basic Building Blocks of Readiness ....................... 67 

Figure 58: Students’ Top Five Readiness Strengths & Challenges ................................................................................ 68 

Figure 59: Number of Children Receiving Services from Multiple First 5 Partners ...................................................... 69 

Figure 60: Percentage of Children Receiving Services from Multiple First 5 Partners ................................................. 69 

Figure 61: Average Cost per Client, by Goal Area and Partner (2010‐2011) ................................................................ 71 

Figure 62: Balance Sheet, Fiscal Year 2010‐2011 ......................................................................................................... 72 

Figure 63: Amount of Leveraged Investments By Type ................................................................................................ 73 

Figure 64: Total Amount of First 5 and Leveraged Investments, 2010‐11 ................................................................... 73 

Figure 65: Number of 2‐1‐1 Callers and Needs, 2010‐11 ............................................................................................. 74 

Figure 66: Types of 2‐1‐1 Callers’ Needs ...................................................................................................................... 74 

Figure 67: Types of 2‐1‐1 Referrals to Agencies ........................................................................................................... 75 

Figure 68: HCOC Child Health Insurance Enrollment, Renewal, and Utilization Percentages ...................................... 82 

Figure 69: Newborn Enrollment Project Statistics, 2010‐11 ........................................................................................ 83 

Figure 70: Number of Emergency Department Visits (Infants Less Than One Year Old).............................................. 84 

Figure 71: Case Flow Diagram (2010‐11) ..................................................................................................................... 87 

Figure 72: Percentage of Families Together Participants Who Showed Decreased Risk of Child Maltreatment ......... 88 

Figure 73: Change in Families Together Participant’s Risk Levels Over Time, 2007 ‐ 2011 ......................................... 88 

Figure 74: Percentage of Families Together Participants Who Do Not Have a Substantiated Allegation of 

Maltreatment Within 6 Months After Case Closure ................................................................................... 89 

Figure 75: Parents’ Satisfaction with Various Aspects of the Triple P Program ........................................................... 90 

Figure 76: Estimated Percentage of Parents in Each Level of Triple P (2010‐11) ....................................................... 100 

Figure 77: How Participants First Heard about Triple P (2010‐11) ............................................................................. 100 

Figure 78: Percentage of Parents Participating with Another Adult (2010‐11) .......................................................... 101 

iv FIRST 5 SANTA CRUZ COUNTY

FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT TABLE OF FIGURES 

Figure 79: Ages of Children Chosen as the “Index” Child* (2010‐11) ........................................................................ 101 

Figure 80: Percentage of Parents Who Needed Assistance to Complete the Assessments (2010‐11) ...................... 101 

Figure 81: Parents’ Use of Positive Discipline Styles .................................................................................................. 104 

Figure 82: Level of Parent Confidence ....................................................................................................................... 107 

Figure 83: Levels of Conflict Over Parenting .............................................................................................................. 109 

Figure 84: Feelings of Support in Their Role as a Parent ............................................................................................ 111 

Figure 85: Level of Parents’ Satisfaction with Their Relationship .............................................................................. 113 

Figure 86: Level of Parents’ Emotional Difficulties ..................................................................................................... 115 

Figure 87: Level of Parental Problems with Child Behavior ....................................................................................... 118 

Figure 88: Participants with a Substantiated Allegation of Child Maltreatment Occurring Up to 6 Months after 

Program Entry ........................................................................................................................................... 120 

Figure 89: Parents’ Satisfaction with the Triple P Program: Levels 3 (Multi‐session), and Levels 4 and 5 ................. 121 

Figure 90: Parents’Satisfaction with the Triple P Seminars/Workshops .................................................................... 122 

Figure 91: Levels of Parenting Difficulty Six Months After Triple P Services .............................................................. 124 

Figure 92: Parenting Difficulty Six Months After Triple P Services: Frequency of Each Response Option ................ 124 

Figure 93: Number of Practitioners Trained and Accredited with Triple P (2009‐11) ................................................ 125 

Figure 94: Summary of Parent Consultation Skills Checklist Ratings (2010‐11) ......................................................... 126 

Figure 95: Summary of Training Evaluation Survey Ratings (2010‐11) ...................................................................... 127 


Figure 97: Parents’ Use of Positive Discipline Styles: Overall ..................................................................................... 134 

Figure 98: Level of Parental Problems with Child Behavior ....................................................................................... 136 

Figure 99: Parents’ Satisfaction with Various Aspects of the Triple P Program ......................................................... 137 


Figure 101: Number of Early Childhood Educators Who Have Completed SEEDS trainings (2007‐2011) .................... 144 

Figure 102: Number of SEEDS Trained Early Childhood Educators in Licensed Programs, by type of classroom 

(2007‐2011) ............................................................................................................................................... 144 

Figure 103: Primary Language of SEEDS Trained Early Childhood Educators in Licensed Programs (2007‐2011) ....... 144 

Figure 104: Educational Attainment of SEEDS Trained Early Childhood Educators in Licensed Programs 

(2007‐2011) ............................................................................................................................................... 145 

Figure 105: Classroom Support for Language and Literacy, 2010‐2011 ....................................................................... 146 

Figure 106: Key Language and Literacy Questions (2007‐2011).................................................................................. 147 

Figure 107: Average FCCERS Scores at Pre and Post Assessment on Literacy‐Related Items (2009‐2011) .................. 147 

Figure 108: Average ITERS Scores at Pre and Post Assessment on Literacy‐Related Items (2009‐2011) .................... 148 

Figure 109: Percentage of All Children Scoring “At” or “Above” the Target Level in Three Pre‐Literacy Skill 

Areas, 2010‐2011 ...................................................................................................................................... 149 

Figure 110: Percentage of Children Scoring “At” or “Above” the Target Level in Three Pre‐Literacy Skill Areas, 

by Primary Language, 2010‐2011 .............................................................................................................. 150 

Figure 111: Percentage of Children Meeting Targets for Later Reading Success, by Primary Language ...................... 150 

Figure 112: Percentage of Children at Each Target Level in Three Pre‐Literacy Skill Areas, by Primary 

Language, 2010‐2011 ................................................................................................................................ 151 

Figure 113: Changes in How Frequently Parents Read With Their Child, 2010‐2011 .................................................. 154 

Figure 114: Percentage of Children Who Made Developmental Changes in Key Social and Pre‐Literacy 

Measures ................................................................................................................................................... 157 

Figure 115: Number of Child Snapshot Forms Collected from Participating Preschool Programs ............................... 159 

Figure 116: Students’ Average School Readiness Levels Across the Basic Building Blocks of Readiness ..................... 159 

Figure 117: Students’ Top Five Readiness Strengths .................................................................................................... 160 

Figure 118: Students’ Top Five Readiness Challenges .................................................................................................. 160 

Figure 119: Percentage of Participants Who Responded “Very Much” to Workshop Survey Questions ..................... 162 

Figure 120: Summer Pre‐K Academy Letter Sound Identification Results, 2011 ......................................................... 164 


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TABLE OF FIGURES FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT 

Figure 121: Percentage of Summer Pre‐K Academy Students who Increased Their Letter Sound Recognition By 

At Least 5 Letter Sounds ........................................................................................................................... 164 

Figure 122: Average Increase in the Number of Letter Sounds Recognized by Summer Pre‐K Academy Students ..... 164 

Figure 123: MESRP Letter Sound Identification Results, 2011 ..................................................................................... 166 

Figure 124: MESRP Students’ Average Scores on the Brigance Preschool Screen‐II Assessment ................................ 166 

Figure 125: MESRP Students’ Average Scores on the Peabody Picture Vocabulary Test ............................................. 167 

vi FIRST 5 SANTA CRUZ COUNTY

FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT EXECUTIVE SUMMARY 

EXECUTIVE SUMMARY 


1

EXECUTIVE SUMMARY FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT 

2 FIRST 5 SANTA CRUZ COUNTY


EXECUTIVE SUMMARY 

The Importance of Investing in Young Children 

A growing body of scientific evidence points to the economic and societal impacts of wise 

investments in the early years. The Harvard Center for the Developing Child states: 

A vital and productive society with a prosperous and sustainable future is 

built on a foundation of healthy child development. Health in the 

earliest years lays the groundwork for a lifetime of vitality. 1 

Experiences during the first few years of life – good and bad – 

literally shape the architecture of the developing brain. Stable, 

positive relationships with adults and growth‐promoting 

experiences are keys to the development of the architecture that 

forms the foundation for all future learning, behavior, and health. 

When we invest wisely in children and families, the next generation 

will pay that back through a lifetime of productivity and responsible 

citizenship. 2 

First 5 Santa Cruz County is dedicated to giving children the 

opportunities they need to reach their full potential. 

Overview of this Report 

The Strategic Plan for 2009‐2012 articulates community goals 

and results in three goal areas: Healthy Children, Strong Families, 

and Children Learning and Ready for School, and also addresses 

improved services for young children and their families. 

1 http://developingchild.harvard.edu/library/ 

2 http://developingchild.harvard.edu/initiatives/council/ 


First 5 Santa Cruz 

County’s Vision: 

All Santa Cruz County 

children enter school 

ready to achieve to their 

greatest potential. 

First 5 Santa Cruz 

County’s Mission: 

To help children succeed in 

school and in life, First 5 

Santa Cruz County invests in 

health, early learning, and 

family support to promote 

optimal development of 

Santa Cruz County children. 

This annual report summarizes 

findings of the First 5 Santa Cruz County 

evaluation from July 1, 2010 to June 30, 2011. The Healthy Kids 

Initiative, Differential Response Initiative, and Early Literacy 

Foundations Initiative are multi‐year investments and, 

therefore, some information presented reflects multiple years 

of data. 

3


Overall Well-Being of Children in the County 

First 5 Santa Cruz County invests in health, early learning and family support to promote the well‐ 

being of children. To help guide its investments and partnerships, First 5 monitors county‐wide 

trends that affect child well‐being. The year 2010‐2011 marked the second year of the current three 

year strategic plan, and the following data reflect the current status of the County: 

� Santa Cruz County has a growing and diverse population of young children. In 2011, there 

were 21,258 children ages 0‐5, the majority of whom were either Hispanic (57%), or White 

(37%). This diversity continues into kindergarten, where in 2010 

almost 49% of children had a primary language other 

than English. 

� Unemployment has grown dramatically and still varies greatly 

across the county. Over the past three years, the County’s 

unemployment rates reflected the broader economic recession. 

Using annual averages, the unemployment rate for the county 

jumped dramatically from 7% in 2008 to 11% in 2009, but 

appears to have reached a plateau by 2011 at almost 13%. Within 

the County, the percent of unemployed residents differed greatly 

by area; the August 2011 unemployment rate ranged from 4% in 

Aptos to 22% in Watsonville. 

“Children have been 

among those hardest 

hit by the [economic] 

crisis.” 

- Lynch, Rene. “Children are 

hidden victims of the economic 

crisis, report says.” Los Angeles 

Times, 17 August 2011. 

 

Image: africa/FreeDigitalPhotos.net 

� There was rising enrollment in public assistance programs. Between 2008 and 2010, the 

total number of County residents participating in CalWORKS increased 8%. In addition, more 

residents have been utilizing publicly‐funded health insurance programs. Between 2007 and 

2011, there were enrollment increases in Medi‐Cal (10%), and Healthy Families (28%). 

Enrollment in Healthy Kids has shown a slight decrease in the last four years, due to 

the waiting list for children ages 6‐18. 

� Enrollment in public assistance nutritional programs has 

increased. In the last few years, there has been an increase in the 

number of residents participating in CalFresh (Food Stamps), the 

National School Lunch Program, and Women, Infants, & Children 

Program (WIC). 

� Not enough mothers are receiving prenatal care in the first trimester. 

The percentage of mothers who received prenatal care in their first trimester is high – 83% — 

but not high enough, especially for teen moms. The Healthy People initiative recently 

lowered its target rate for first trimester prenatal care from 90% (2010 Objective) to 78% 

(2020 Objective), with the result that, on average, Santa Cruz County is achieving this 



objective. However, younger mothers tended to fall below this target rate (ages 24 and 

younger). 

Additionally, there were differences in receipt of early prenatal care based upon the 

mother’s source of payment for the care. Only 76% of mothers with Medi‐Cal began receiving 

prenatal care during the first trimester, compared to 92% of mothers with private insurance. 

� The percentage of births to teen mothers in the County is slowly decreasing. In 2010, there 

were 258 births to teen mothers, representing 8.1% of all births in Santa Cruz County, and a 

teen birth rate of 30 per 1,000 (ages 15‐19). Over the past five years there has been a slight 

decrease in both births to teen mothers and the teen birth rate, except for 2009 when there 

was a small increase in both measurements. Taken together, the two measures indicate a 

slowly decreasing proportion of teens in the county who are becoming mothers. 

� Over half of the births by women in the County were paid for by Medi‐Cal. In 2010, 55% of 

births, across all age groups, were paid for by Medi‐Cal. Medi‐Cal was utilized by over 84% of 

the births to women under the age of 25. 

� Young children are receiving services for their special needs. In participating preschools, 

approximately 6% of children have had an Individualized Education Plan (IEP) or an 

Individualized Family Service Plan (IFSP) developed for them, and 6% of kindergarteners are 

receiving special education services. 

A Profile of First 5 Participants 

First 5 Santa Cruz County reaches children who can make great gains 

with early and smart investments. 

First 5’s goal is to serve the most vulnerable children ages 0‐5 and their families in Santa Cruz 

County, including very low‐income families, English language learners, and families who live in 

higher risk zones of the county. 

� First 5‐supported programs are wide‐reaching: In 

2010‐11, First 5 partners served 9,292 children 

(unduplicated), representing over two‐fifths of all 

children these ages (44%) in Santa Cruz County. 

� First 5 serves a high number of dual language 

learners: Of the children served by First 5, 85% were 

Latino, and 71% of participants spoke Spanish as their 

primary language. Of all Latino children ages 0‐5 in Santa Cruz County, 62% participated in 

services funded by First 5. 


5


� First 5 is reaching an increasingly low income population. Almost 89% of the families served 

by First 5 earned less than the Federal Poverty Level, based on data for a family of five (the 

typical family size served by First 5). This also represents an increase from 78% since 2007‐08. 

� First 5 is serving children in the highest risk zones of the county. Of the children served who 

had known ZIP codes, most (92%) lived in the areas of the county that rank highest on a 

cumulative index of risk factors that included measures of linguistic isolation, family income, 

birth statistics, parental education attainment, child maltreatment and family violence. These 

areas include Watsonville, Freedom, Live Oak, and some areas in the city of Santa Cruz. 

First 5 strengthens systems by enhancing the capacity of service 

providers 

In addition to supporting direct services to children and families, First 5 aims to boost the capacity of 

local systems in order to extend the reach of critical early education, family support, and health 

services to a larger number of children and families. Systems enhancements help ensure better 

services for years to come. Examples of First 5’s capacity‐building work in 2010‐2011 include: 

� Skill development and coaching for early childhood educators. Training of approximately 

125 early childhood educators to deliver the SEEDS of Early Literacy research‐based 

strategies in their classrooms or homes; 

� Improved parent and caregiver practices that 

support children’s social and emotional 

development. Training of 86 parent education 

practitioners to deliver the Triple P curriculum, an 

evidence‐based curriculum shown to increase 

parental efficacy, parent‐child interaction, child 

behaviors and to reduce rates of child 

maltreatment; 

� Support for children’s transition to kindergarten. 

Training of teachers in 42 preschools to prepare Child Snapshots, a transcript of parent 

information and child skills that is delivered to children’s elementary schools. The Snapshots 

are intended to stimulate information sharing, dialogue and coordination between early 

education providers and elementary schools; and 

� Distribution of information to community service providers. Training of health, social 

services, and early education providers through workshops, brown bag lunches, and other 

trainings to better integrate services and improve customer service. 



Healthy Children 

Though coverage rates are high in the county – approximately 93% – there are still children who do 

not have health insurance. For the past several years, First 5 Santa Cruz County has invested in 

strategies to help ensure that all children have access to care. 

First 5 Santa Cruz County insures children 

� First 5 helps uninsured children enroll in health plans: In 2004, First 5 Santa Cruz County 

helped create a new children’s health initiative called Healthy Kids. Healthy Kids has Certified 

Application Assisters who provide outreach and assistance to income‐eligible families to help 

them apply for public health insurance, and to renew their coverage annually. Because Medi‐ 

Cal and Healthy Families cannot cover all of the uninsured, First 5 also funds the premiums 

for Healthy Kids members. 

� Children are getting enrolled in public health insurance plans. Since the start of the Healthy 

Kids Initiative (June 1, 2004‐June 30, 2011), there were 1,134 new enrollments of children 

ages 0‐5 in the local Healthy Kids program, 3,371 children in Healthy Families, 

and 2,983 children in Medi‐Cal, for a total of 7,488 new enrollments of 

Since 2004, 7,488 children 

ages 0‐5 have been enrolled 

children ages 0‐5. 

in public health insurance. 

� Children are renewing and using their health insurance. In 

order to ensure continuity of care, it’s important that parents keep 

In 2010‐11, 71% of all 

mothers with Medi‐Cal 

births had their new babies 

their children enrolled in health insurance plans. During the 2010‐11 

funding cycle, the Certified Application Assisters helped ensure that 

enrolled in Medi‐Cal. 92% of children ages 0‐5 renewed their membership in public health 

insurance. Of the renewal applications that were accepted, 

approximately 53% were in Healthy Families, 32% were in Medi‐Cal, and 14% 

were in Healthy Kids. Almost 97% of children renewing in public health insurance utilized 

care prior to renewal. 

� Santa Cruz County’s newborns are getting connected to medical 

care. Baby Gateway—the Newborn Enrollment Project—has now 

been launched in three local hospitals. While this program has been 

active, 70% of all mothers this year received a newborn visit while 

in the hospital. Baby Gateway also assisted 74% of all mothers 

with Medi‐Cal births to complete a Medi‐Cal application for their 

new babies. With this assistance, 71% of all mothers with Medi‐ 

Cal births had their new babies enrolled in Medi‐Cal, and 72% 

were assigned a primary care provider for their child. 


7


First 5 Santa Cruz County children get a medical home, preventive 

care, and dental care 

� Children have a medical home. Nearly all children (95%) ages 2‐6 who were enrolled in 

Healthy Kids had access to a primary care practitioner, according to the 2010‐11 HEDIS 

measures. 3 The majority of children (ages 3‐6) in Healthy Kids also had a well‐child visit 

(83%). 

� Fewer children are using the emergency 

department (ED). Ideally, children and their 

families who have insurance and who have a 

medical home will be more likely to access their 

provider for routine preventive care, and less 

likely to use the emergency department (ED) for 

non‐urgent medical care. 

o The rate of ED use for children using Healthy 

Kids insurance was increasing up through 2008, but has shown a decrease since 2009. 

o The services provided by the Newborn Enrollment Project may also have had an effect on 

the use of the ED for children less than one year old. ED visits at Watsonville Community 

Hospital were at a high of 632 in the 2nd quarter of 2009. Baby Gateway was launched at 

that hospital in August 2009, and after that the number of ED visits has dropped steadily 

to a low of 424 at the beginning of 2011. 

� Children are getting dental care. Of children ages 4‐6 enrolled in Healthy Kids in 2010, the 

majority (89%) had a dental visit in the past year. This percentage has been slowly increasing 

since 2006 (69%). A smaller percentage of younger children (ages 2‐3) are getting dental 

visits, although this too has been increasing between 2006 (49%) and 2010 (69%). 

3 HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures used by the Health Care Quality 

Measurement (HCQM) annual report to track the quality of care that children enrolled in Healthy Kids are receiving in Santa Cruz 

County. HEDIS results are analyzed for the calendar year; therefore, 2010 results are for the time period January 1 ‐ December 31, 2010. 



Strong Families 

Santa Cruz County historically has had higher rates of child abuse and neglect than any other Bay 

Area county. 4 Fortunately, the rates of child maltreatment are decreasing and in 2010 the county 

rate (7.6 per 1,000) dropped lower than the state‐wide rate (8.7 per 1,000) for the first time in 

reporting history. 

First 5 Santa Cruz County helps strengthen parent‐child relationships 

and reduce risk for child abuse and neglect 

Through two innovative programs, First 5 and its partners are helping to decrease the risk and 

incidence of child abuse and neglect. 

� In partnership with the county’s Human Services Department‐Family and Children’s Services 

and Santa Cruz Community Counseling Center, First 5 supports a program 

called Families Together. Families Together is Santa Cruz County’s 

differential response program, a strategy used to intervene early 

At‐risk parents have improved 

with families in which there has been an allegation of abuse. 

parenting styles and reduced 

This home visiting program includes comprehensive intake 

risk of maltreatment. 

and risk assessment, development of a tailored case plan, 

parent support and education, child development activities, 

The percentage of Families 

and periodic assessments. Results of the program have been Together participants assessed 

as being at high risk or very high 

very encouraging: 

risk of child maltreatment 

dropped from 62% to 13%. 

o Reduction of risk. Parents/primary caregivers receiving 

services from Families Together had their levels of risk assessed 

while they were in the program. Pre and post risk assessments for 

several years combined indicated that families reduced their level of risk for future 

maltreatment. 

o Reduced rates of child maltreatment. Of the 82 participating families who had their cases 

closed in 2011, 96% had no substantiated allegations of maltreatment in the 6 month 

period following case closure. 

� First 5 continued the implementation of the Positive Parenting Program, or Triple P. The 

program consists of five levels of intervention, from broad‐based, universal efforts in the 

community to more intensive, focused efforts with individual parents. The Triple P model is 

an evidence‐based program shown in numerous randomized studies to increase parental 

4 Center for Social Services Research, School of Welfare, U.C. Berkeley. Child Welfare Dynamic Report System, A California Department of 

Social Services / University of California at Berkeley collaboration. Accessed online at http://cssr.berkeley.edu/ucb_childwelfare. 


9


confidence and efficacy, positive parent‐child interactions and child behaviors, and to reduce 

rates of child maltreatment. Highlights of this program include: 

o Evidence‐based parenting support is available. First 5 has implemented all five levels of 

Triple P in Santa Cruz County, from the launch of a media campaign to intensive and 

focused individual services. In 2010‐11, approximately 893 parents with 1,518 children 

participated in the program. 

o Parents are engaged and seek more opportunities. Of parents who participated in the 

seminars and workshops, 21% requested follow‐up services, suggesting that these brief 

services may be an effective way of getting parents engaged in the program and gives 

them an opportunity to participate in further services. 

o Parenting skills and knowledge are improving along several domains. Parents who 

participated in levels 3 and 4 of the Triple P program completed assessments that 

measured their levels of parenting skills and knowledge along several domains. Results 

showed significant improvements in all domains, including: 

Increased use of positive discipline styles � Improved levels of confidence in 

parenting � Reduced levels of conflict over parenting � Increased support in 

their role as a parent � Increased levels of satisfaction with their relationship � 

Decreased levels of emotional difficulties � Improvements in child behavior 

There was also evidence that parents who had more serious parenting issues made the 

most meaningful changes in their family lives. 

o Satisfaction with services. Parents have rated the quality of 

services very high, noting that they had received the help they wanted, 

Parents are more 

confident in their 

parenting skills, are 

were dealing more effectively with problems in their family, and would 

come back to the program if they needed to seek help again. 

helping to improve their 

o Continued use of the skills they learned. On average, 

children’s behavior, and 

are building positive 

relationships with their 

families. 

parents felt that the seminars answered their questions, and that they 

would continue to use the strategies they learned. Additional survey 

results indicate that six months after their Triple P services, parents felt 

highly effective in dealing with their children’s behavior, and reported 

improved child behavior overall. 

o Lowered rates of child maltreatment. Among families who have experienced child abuse 

or neglect, results suggest that Triple P is associated with lower rates of new 

substantiated child maltreatment allegations. Six months after beginning a Triple P 

program, only 1% of parents had a new substantiated maltreatment allegation, compared 

to 5% of parents in a comparison parenting program. 



Children Learning and Ready for School 

One of the most powerful indicators of later success is a child’s reading proficiency at the end of 3 

“The seeds of literacy are 

planted before children 

enter school. 

Important literacy skills do 

not develop spontaneously, 

instruction shapes them.” 

- Snow, Burns, & Griffin, 1998 

rd 

grade, 5 and data show that Santa Cruz County children are struggling with their reading skills. For 

example, only 40% of 3 rd grade students in the County scored proficient or better on the 

standardized California English Language Arts test (STAR) in 2010, as compared to 

46% statewide. The good news is that there has been a gradual increase in 

the past five years in the percentage of county students who are scoring at 

or above grade level (from 34% in 2007 to 40% in 2011), and county 

areas of historically low performance have shown particularly great 

improvements in scores. 

First 5 Santa Cruz County is helping to improve children’s school 

performance by encouraging families to read together, providing language 

and literacy skill development for early childhood educators, encouraging 

child assessments and differentiated instruction, and working to help children 

smoothly transition into kindergarten. 

First 5 Santa Cruz County builds early literacy foundations by 

training early childhood educators to enhance language rich 

practices in the classroom 

� Early childhood educators are getting trained in literacy activities. Since January 2007, 

First 5 has invested in early literacy training for 356 early childhood educators through the 

SEEDS of Early Literacy courses at Cabrillo College. 

356 early child educators 

are now promoting strong 

language and literacy 

foundations for children. 

Over 7,000 children are 

developing the skills to 

become successful readers. 


� The SEEDS curriculum is being used throughout Santa Cruz County 

child care programs and preschools. Since the founding of the Early 

Literacy Foundations Initiative in 2006‐07, 201 SEEDS‐trained teachers and 

coaches are working in state‐ and federally‐subsidized classrooms, there 

are 155 licensed family child care providers, teachers, and coaches in 

private and non‐profit centers/homes, and 155 Family, Friend or Neighbor 

(FFN) informal child care providers. 

� Classrooms and home‐based settings of SEEDS‐trained early educators 

are being transformed into literacy‐rich environments. SEEDS‐trained early childhood 

educators are working to ensure their children are on target for kindergarten by using 

evidence‐based early literacy strategies, receiving on‐site coaching, and integrating materials 

into their learning environments. Assessment results are showing that SEEDS‐coached 

5 United States Department of Education, Promoting Educational Excellence for all Americans, Questions and Answers on No Child Left 

Behind, retrieved from http://www.ed.gov/nclb/methods/reading/reading.html, 2004. 

11


teachers are improving the quality of support they provide in their classrooms for children’s 

development of early literacy: 

o In preschool classrooms teaching children ages 3‐5, results from the Early Language and 

Literacy Classroom Observation tool (2010‐11) show that the percentage of classrooms 

that provided high quality support for early literacy increased from 16% at pre‐assessment 

to 92% at post‐assessment. 

o In home‐based settings, results from multiple years of the Family Child Care 

Environmental Rating Scale (2009‐11) indicated that family child care providers made 

improvements in their interactions with children, their use of books with children, and in 

helping children understand and use language. 

o In infant/ toddler classrooms, results from multiple years of the Infant Toddler 

Environmental Rating Scale (2009‐11) revealed that teachers made improvements in the 

way they interacted with children, used books with children, and helped children 

understand and use language. 

First 5 Santa Cruz County helps children build the foundation for 

later reading success 

� Parents are getting involved in their children’s reading. SEEDS 

classrooms also implemented Raising A Reader, a weekly rotating 

book bag program for families, to boost shared reading practices 

and impact children’s early literacy skills. Over 5,000 children 

participated in the program during 2010‐2011. 

� Children are developing skills in key areas of reading success. 

Many preschool classrooms throughout the county are taught by 

teachers who have received SEEDS training funded by First 5. 

Results show that children benefit when teachers enhance their 

skills to promote early literacy. 

o When they used child assessment data to tailor their instruction with children, children in 

these SEEDS‐trained classrooms increased their skills on 3 key predictors of later reading 

success (picture naming, rhyming, and alliteration). 

o A higher percentage of Spanish‐speaking children scored “below” or “near” target levels in 

their initial assessments when compared to English‐speaking children, but by the last 

assessment, they had reached or exceeded the levels attained by English‐speaking 

children, particularly in rhyming and alliteration, in both languages. 

� Children are learning letter sounds. In 2010‐11, 90% of children in two pre‐kindergarten 

educational programs provided by Migrant Education increased their letter sound 

recognition by at least five letter sounds. On average, children recognized only 1 letter sound 

before the program and 18 letter sounds after the program. 



First 5 Santa Cruz County helps children successfully transition to 

kindergarten 

First 5 is investing in activities that help children successfully transition to kindergarten. Some ways 

to do this are to encourage parents to visit the new school with their child, to meet the new 

kindergarten teacher, and to attend parent orientations. The following highlights First 5’s work to 

support successful transitions to kindergarten: 

� First 5 Santa Cruz County is working with parents and early childhood educators to create 

an information “bridge” for children as they transition to kindergarten. Since 2006, parents 

and early childhood educators have filled out Child Snapshot forms about children before 

they enter kindergarten. Each Snapshot includes key parent information about their child, as 

well as the preschool teacher’s assessment of the child’s school readiness skills. These forms 

help schools understand their incoming kindergarteners to thereby build balanced 

classrooms, attend to individual child and family needs, and to create greater articulation 

between preschool and kindergarten. 

o This spring, teachers and parents at 42 preschools completed individual Child Snapshot 

forms for 976 children, which were then collected and distributed to the kindergarten 

teachers at each child’s school of attendance. 

o Average readiness scores indicated that children who attended these preschools will be 

entering kindergarten with high levels of proficiency across all domains of readiness. 

� Parents are receiving kindergarten transition information. 

o In February 2011, First 5 co‐sponsored the Pajaro Valley 

Unified School District’s Parent Conference. Over 300 families 

participated in workshops promoting transition to 

kindergarten practices, healthy child development, and 

positive discipline. 

o Approximately 267 parents participated in Transition to 

School Workshops where they learned about kindergarten 

registration requirements, choices of language programs, 

how to support their child in school, and ways to ensure that 

their child’s entry into school is a pleasant and smooth transition. 

Service Integration & Community Strengthening 

First 5 efforts are sustainable 

� Partners maximize First 5 investments by leveraging these funds to draw down other matching 

funds. In 2010‐11, First 5 partners leveraged $3,762,964, more than the entire First 5 Santa 

Cruz County annual program investment of 3,662,823. 


13


Summary 

First 5 Santa Cruz County is serving 44% of children ages 0‐5 in Santa Cruz County, and they are 

serving the most vulnerable children, including those in families that are experiencing severe 

poverty and are living in areas of the county with the highest risk factors. 

First 5 and its partners are achieving results in helping these very vulnerable children and families: 

� In the Healthy Children goal area, data show that children are insured and using preventative 

health care: 

o Since 2004, 7,488 children ages 0‐5 have been enrolled in public health insurance. 

o In 2010, 95% of children (ages 2‐6) in Healthy Kids had a medical home, 83% of children 

(ages 3‐6) had a well‐child visit in the last year, and 89% of children (ages 4‐6) had a dental 

visit. 

o In 2010‐11, Baby Gateway assisted 74% of all mothers with Medi‐Cal births to complete a 

Medi‐Cal application for their new babies. With this assistance, 71% of all mothers with 

Medi‐Cal births had their new babies enrolled in Medi‐Cal, and 72% were assigned a 

primary care provider for their child. 

� In the Strong Families goal area, families are becoming more healthy and resilient, and it 

benefits their children: 

o Families who are at risk for child abuse and neglect are being helped to reduce that risk. 

o 96% of families who received services from the Families Together program had no 

substantiated allegations of maltreatment in the six months after their cases closed. 

o First 5 has implemented all five levels of Triple P in Santa Cruz County, from the launch of 

a media campaign to intensive and focused individual services. Brief services may be an 

effective way of getting parents engaged in the program and provide an opportunity to 

participate in further services. 

o Parents participating in the Triple P parenting program significantly increased their 

confidence in parenting, used more positive discipline styles, felt more supported, and 

improved their relationships with their families. 

o Parents who had more serious parenting issues made the most meaningful changes in 

their family lives. 

o Up to six months after completing the program, Triple P parents continue to report fewer 

behavioral problems with their children, and are continuing to use the skills they learned. 

o Among families who have experienced child abuse or neglect, results suggest that Triple P 

is associated with lower rates of new substantiated child maltreatment allegations. 



� In the Children Learning and Ready for School goal area, data show that First 5 is successfully 

building teacher skills to improve children’s later school success: 

o The SEEDS of Early Literacy approach is transforming the early education system in the 

county. In 2010‐11, the percentage of SEEDS‐trained preschool classrooms assessed as 

providing high quality literacy support for children increased from 16% to 92%. Similarly, a 

multiple year analysis showed that SEEDS‐trained family child care providers increased 

their abilities to help children use books, and understand and use language, and SEEDS‐ 

trained Infant/Toddler teachers showed improvements in these same dimensions. 

o Children in SEEDS‐trained classrooms are increasing their skills in three predictors of later 

reading success (picture naming, rhyming and alliteration). Further analyses showed that a 

higher percentage of Spanish‐speaking children scored “below” or “near” target levels in 


assessment, they had reached or exceeded the levels attained by English‐speaking 

children, particularly in rhyming and alliteration, in both languages. 

o Child Snapshots are helping the kindergarten teachers of 976 children understand their 

strengths, as well as areas in which they can be supported for success in school. 

� First 5 partners are maximizing First 5 funding by leveraging their funds to bring in an 

additional 3.7 million dollars, and in fact, the amount leveraged exceeds First 5’s total 

funding for 2010‐11 by over $100,000. Because of First 5’s funding and this kind of additional 

support, Santa Cruz County children will continue to get the help they need to become 

healthy, strong, and ready for school. 


15



FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT STRATEGIC FRAMEWORK RESULTS 

PART 1: 

STRATEGIC FRAMEWORK RESULTS 


17

STRATEGIC FRAMEWORK RESULTS FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT 



Overview of the Strategic Framework 

In the First 5 Santa Cruz County Strategic Plan for 2009‐2012, the Commission articulated a strategic 

framework that included community goals and desired program results. In each of the three goal 

areas (Healthy Children, Strong Families, and Children Learning and Ready for School), specific 

results were chosen to receive Commission investment between 2009 and 2012. A detailed version 

of this framework is included in Appendix I, and an overview is as follows: 

Increase 

Insurance 

Coverage 

Increase Medical/Dental 

Homes 

Decrease Child 

Abuse & 

Neglect 


Healthy Children 

Increase Number of 

Children Reaching 

Developmental 

Milestones 


Decrease 

Childhood 

Obesity 

Increase use of 

Preventative Health Care 

Increase Participation in 

Quality Structured 

Activities 

Improve Parent & Caregiver 

Practices that Support Social 

and Emotional Development 

Improve Pre‐Literacy 

Skills 

Preview of the Strategic Framework Section of this Report 

Increase Parental 

Involvement in 

Children’s Learning & 

Development 

Children Learning 

and Ready for 

School 

Increase Use of 

Quality Child 

Care Practices 

Increase Use of Kindergarten 

Transition Practices 

The Strategic Framework is also the framework for the evaluation. Thus, the Strategic Framework 

section of this report reviews the progress that has been made between July 1, 2010 and June 30, 

2011 toward achieving the specific results in each of the three goal areas. Multiple years of data are 

often shown for initiatives for which there have been multiple years of investment. To contextualize 

these outcome data, this section begins with a review of county‐wide trends as well as a profile of 

First 5’s participants, and concludes with a section regarding First 5 Santa Cruz County’s efforts to 

support service integration and community strengthening. 

19



OVERALL WELL-BEING OF CHILDREN 


IN THE COUNTY 

Overall Well‐Being of Children in the County 

A Profile of Santa Cruz County’s Youngest Children 


COUNTY TRENDS 

Santa Cruz County has a growing and diverse population of young children. In 2011, there were 

21,258 children ages 0‐5, the majority of whom were either Hispanic (57%), or White (37%). This 

diversity continues into kindergarten, where in 2010 almost 49% of children had a primary language 

other than English. 

Figure 1: Number of County Children ages 0-5 

Figure 2: Ethnicity of County Children 

ages 0-5 (2011) 

3.5% 

1.1% 

22,000 

18,000 

14,000 

10,000 

57.3% 

1.4% 

18,216 18,382 18,678 18,971 19,209 

21,258 

2006 2007 2008 2009 2010 2011 

36.7% 

White 

Hispanic 

Asian/Pacific Islander 

Other 

Multirace 

Figure 3: English Language Proficiency of 

County Kindergarteners (2010) 

47.0% 

51.5% 

Source: (Population and Ethnicity) State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail, 2000–2050. Sacramento, 

CA, 2011. (English Language Proficiency) California Department of Education, Special Education Division, 2009‐10. 

English Language Proficiency definitions: 

� English Learners (EL) are those students for whom there is a report of a primary language other than English on the state‐approved Home 

Language Survey and who, on the basis of the state approved oral language (grades K‐12) assessment procedures and including literacy (grades 3‐ 

12 only), have been determined to lack the clearly defined English language skills of listening comprehension, speaking, reading, and writing 

necessary to succeed in the school's regular instructional programs. 

� Fluent‐English‐Proficient (FEP) students are those whose primary language is other than English and who have met the district criteria for 

determining proficiency in English (i.e., those students who were identified as FEP on initial identification and students redesignated from Limited‐ 

English‐Proficient (LEP) or English learner (EL) to FEP). 

N: (Population and Ethnicity) N=21,258; (English Language Proficiency) N=3,267. 

1.5% 

English as Primary 

Language 

Fluent‐English‐ 

Proficient (FEP) 

English Learners (EL) 

21


COUNTY TRENDS 

County-Wide Trends in Indicators of Child and Family Well-Being 

Indicator: Trends in employment and public assistance 

The local economy affects all aspects of community well‐being, and one barometer of how a 

community is faring is its trends in employment and associated demand for public assistance. 

As reflected in the following unemployment data for the county, state, and nation, Santa Cruz 

County has been impacted by the current economic climate. During the recession, the market 

contracted and became less able to absorb the workforce, which has resulted in increased 

unemployment. 

� Between 2006 and 2011, the County unemployment rate increased from 5.7% to 12.7%. 

� Within the County, the percent of unemployed residents differed greatly by area; the August 

2011 unemployment rate ranged from 4% in Aptos to 22% in Watsonville. 

Figure 4: Unemployment Rate 

24% 

20% 

16% 

12% 

8% 

4% 

0% 

4.9% 

5.7% 

4.6% 

5.9% 

4.6% 

7.3% 

5.4% 7.2% 

5.8% 

11.4% 


9.3% 

22.4% 

12.8% 12.7% 

12.4% 

12.0% 

Source: U.S. Department of Labor, Bureau of Labor Statistics, 2011. 

* Data for 2006‐2010 reflect the average monthly unemployment rate for each year. Data for 2011 reflect the average monthly rate through August 

(the most current month available at the time of this report). 

22 FIRST 5 SANTA CRUZ COUNTY 

9.6% 

9.0% 

4.2% 

2006 2007 2008 2009 2010 2011* 

Watsonville, CA 

Santa Cruz County 

California 

United States 

Aptos, CA



COUNTY TRENDS 

Unemployment has caused an increase in enrollment in public assistance programs. Between 2008 

and 2010, the total number of County residents participating in CalWORKS increased by 8.1%, with a 

small decrease within the last year. 

Figure 5: County Enrollment in CalWORKS 

5,000 

4,500 

4,000 

3,500 

3,000 

2,500 

4,582 4,589 4,512 

4,951 4,877 

2006 2007 2008 2009 2010 

Source: State of California Employment Development Department, Labor Market Information Division, Planning Information Packets, 2011. 

In tough economic times, food security can become a challenge for families. In Santa Cruz County, in 

2011 over 19,000 people were receiving Food Stamp benefits, which was a 70% increase from 2007. 

The number of people receiving food stamps was equivalent to about 7% of all people in the 

county, 6 though in 2010 California Food Policy Advocates estimated that 14% of the county 

population was income‐eligible. 7 In 2010, over 19,000 Santa Cruz County children were participating 

in the National School Lunch Program, or almost 50% of the county’s students. Enrollment in WIC 

increased slightly from 9,310 (in 2009) to 9,571 (in 2010). 

Figure 6: County Enrollment in Public Assistance Nutritional Programs 

PROGRAM 2007 2008 2009 2010 2011 

CalFresh (Food Stamp Program) 11,367 12,509 14,372 17,629 19,291 

National School Lunch Program (Free and 

reduced price lunch ) 16,494 16,665 17,666 19,228 

not yet 

available 

not yet 

Women, Infants, & Children Program (WIC) - - 9,310 9,571 available 

Sources: (CalFresh data) California Department of Social Services, Food Stamp Program Participation and Benefit Issuance Report, 2011; (National 

School Lunch Program) California Department of Education, Educational Demographics Unit, 2010; (WIC) 2009 data=California Food Policy Advocates, 

2010 County Nutrition and Food Insecurity Profiles; 2010 data=State of California Department of Health Services, Certified Participants (Receiving F1s), 

Caseload, and Unissued Food Instrument Ratios for All Agencies by Month, 2011. 

Notes: Based on the recommendation of the County of Santa Cruz Human Services Department, the methodology for calculating the CalFresh 

enrollment was changed to be consistent with their reporting procedures. Results are now based on a July‐June fiscal year (e.g., 2006‐07 data are 

reported in 2007), and reflect the average monthly total for each fiscal year. National School Lunch Program results are also based on a July‐June 

fiscal year. 

6 State of California, Department of Finance, Population Projections for California and Its Counties 2000‐2050, Sacramento, California, 2011. 

7 California Food Policy Advocates, 2010 County Nutrition and Food Insecurity Profiles, 2010. 

23


COUNTY TRENDS 

It is also important that families have access to health care. The following figures present enrollment 

trends in publicly‐funded health insurance programs. 

Figure 7: County Enrollment in Medi-Cal 

44,000 

40,000 

36,000 

32,000 

28,000 

24,000 

20,000 

37,804 

39,380 

40,790 41,996 41,629 

Source: State of California, Department of Health Care Services, Research and Analytic Studies Section, Number of Beneficiaries by County, 2011. 

Note: 2007‐2011 data are reported for July of each year. 

Figure 8: County Enrollment in Healthy Families 

7,000 

6,000 

5,000 

4,000 

3,000 

2007 2008 2009 2010 2011 

5,387 

5,856 

6,446 

6,577 

Source: Managed Risk Medical Insurance Board, HFP Montly Enrollment Reports, 2011. 

Note: Results are as of June of each year. 

Figure 9: County Enrollment in Healthy Kids 

2,500 

2,000 

1,500 

1,000 

500 

0 

Source: Healthy Kids of Santa Cruz County, Biannual Evaluation, 2009‐2011. 

Note: Enrollment is the number of children as of June of each year. 


6,871 


17 

1,909 

258 

1,518 

363 

1,313 

265 195 170 

June 2009 June 2010 June 2011 

Waiting list (ages 6‐18) 

Ages 6‐18 

Ages 0‐5


Indicator: Percentage of mothers in the County receiving prenatal care in the first 

trimester 

Prenatal Care in the County 


COUNTY TRENDS 

In 2010, most women in Santa Cruz County received prenatal care during the first trimester of their 

pregnancies (83%). The Healthy People initiative recently lowered its target rate for first trimester 

prenatal care from 90% (2010 Objective) to 78% (2020 Objective), with the result that, on average, 

Santa Cruz County is achieving this objective. However, younger mothers tended to fall below this 

target rate (ages 24 and younger). Additionally, there were differences in receipt of early prenatal 

care based upon the mother’s source of payment for the care. Only 76% of mothers with Medi‐Cal 

began receiving prenatal care during the first trimester, compared to 92% of mothers with private 

insurance. 

100% 

80% 

60% 

40% 

20% 

0% 

Figure 10: Percentage of Mothers in Santa Cruz County Receiving Prenatal Care in the 

First Trimester, by Age 

81% 

83% 

59% 

63% 

72% 75% 75% 

69% 

84% 

86% 87% 87% 

Source: County of Santa Cruz, Public Health Department, Births, Santa Cruz County, 2010. Santa Cruz County, CA. July 2011. 

Note: The data from the report were considered provisional. 

2009 N: Overall=3,290,


COUNTY TRENDS 

Indicator: Percentage of births in the County to teen mothers 

In 2010, there were 258 births to teen mothers, representing 8.1% of all births in Santa Cruz County, 

and a teen birth rate of 30 per 1,000 (ages 15‐19). Over the past five years there has been a slight 

decrease in both births to teen mothers and the teen birth rate, except for 2009 when there was a 

small increase in both measurements. Taken together, the two measures indicate a slowly 

decreasing proportion of teens in the county who are becoming mothers. 

Figure 12: Percentage of Births to Teen Mothers (Ages 19 and under) 

11% 

10% 

9% 

8% 

7% 

9.5% 9.5% 9.5% 

8.7% 

8.5% 

8.6% 

Source: (Santa Cruz County) County of Santa Cruz, Public Health Department, Births, Santa Cruz County, 2010. Santa Cruz County, CA. July 2011; 

California data for 2010 are not yet available. 

Figure 13: Teen Birth Rate (per 1,000, Ages 15-19) 

38 

36 

34 

32 

30 

28 

Source: (Santa Cruz County) County of Santa Cruz, Public Health Department, Births, Santa Cruz County, 2010. Santa Cruz County, CA. July 2011, State 

of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail, 2000–2050. Sacramento, CA, 2010; California data for 2010 are 

not yet available. 


9.7% 

9.2% 

8.1% 

2006 2007 2008 2009 2010 

37.8 

37.1 

36.4 36.4 

35.2 

33.3 

35.5 

32.1 

30.0 

2006 2007 2008 2009 2010 


California 


California


Indicator: Percentage of births in the County with Medi‐Cal insurance coverage 

In 2010, across all age groups, 55% of births were paid for by Medi‐Cal. However, Medi‐Cal was 

utilized by almost 84% of women under the age of 25 who gave birth. 

100% 

80% 

60% 

40% 

20% 

0% 

Figure 14: Percentage of Births in Santa Cruz County Paid by Medi-Cal 

51% 

55% 


77% 

82% 

88% 

83% 

83% 

78% 

48% 

45% 

29% 32% 

Overall 17 and under 18‐19 20‐24 25‐34 35 and over 

2009 2010 

COUNTY TRENDS 

Source: County of Santa Cruz, Public Health Department, Births, Santa Cruz County, 2010. Santa Cruz County, CA. July 2011. 

Note: The data from the report were considered provisional. 

2009 N: Overall=3,290, ≤17=119, 18‐19=200, 20‐24=618, 25‐34=1,709, 35+=644; 2010 N: Overall=3,170, ≤17=89, 18‐19=169, 20‐24=611, 25‐34=1,663, 

35+=639 

Indicator: Percentage of children who are diagnosed with special needs and/or with 

Individualized Education Program (IEP) 

In 2010‐11, 976 parents of children in local preschool programs completed Child Snapshots, in which 

they were asked about their children’s health and developmental history, including whether their 

children had any special needs. 

� As seen in the following figure, almost 6% of parents in preschools that participated in the 

Child Snapshot program indicated that their child had an Individualized Education Plan (IEP) 

or an Individualized Family Service Plan (IFSP). 

� This figure also shows that 6% of kindergarten students in Santa Cruz County received special 

education services. As can be seen from these data, the percentage of children with an IEP in 

the sampled preschool programs is very similar to those in kindergarten, and both samples 

show a gradual decline in IEPs over the last five years. 

27


COUNTY TRENDS 

Figure 15: Percentage of Children in Preschool Programs and Kindergarten Who Have 

Individualized Education or Family Service Plans (IEP/IFSP) 

14% 

12% 

10% 

8% 

6% 

4% 

2% 

0% 

9.0% 

6.7% 

6.6% 6.3% 

7.9% 

5.5% 

6.0% 6.0% 

Sources and Ns: (Preschools rates of IEP) Child Snapshot forms, 2006 – 2011. N= 388 in 2006‐7, 671 in 2007‐8, 580 in 2008‐9, 774 in 2009‐10, and 878 

in 2010‐11. (Kindergraten rates of IEP) California Department of Education, Special Education Division. N= 2909 in 2006‐7, 2921 in 2007‐8, 3031 in 

2008‐09, 3,267 in 2009‐10, 3,149 in 2010‐11. 


5.0% 

5.5% 

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 

Kindergarten 

Preschool


Profile of Participants PROFILE OF PARTICIPANTS 

Number of Children and Families Served 


PROFILE OF PARTICIPANTS 

Since the development of its evaluation system, First 5 Santa Cruz County has had the unique ability 

to gather unduplicated counts of individuals served within partner programs and across those 

programs. These data, or client characteristic data (hereafter referred to as “CCDs”), are submitted 

by partners to First 5 on a quarterly basis. This information is gathered in one of two ways: the Santa 

Cruz County SUN database, or partner‐specific data collection forms. These data are then analyzed 

to determine the unduplicated count of individuals served by program, by goal area, and overall. 8 

Note that not all programs submit data on individual parents and children. 

Figure 16: Total Unduplicated Children and Parents Served, by Goal Area and Age 

GOAL AREA 

CHILDREN 

(AGES 0‐5) 

NUMBER PERCENT 

NUMBER 

(AGES



children and their parents, but have collected CCDs only for the children. These partners include the 

Health Care Outreach Coalition, Raising A Reader, Migrant Education (Summer Pre‐K and School 

Readiness Programs), Side by Side, and the Child Snapshot project. 

Indicator: Percentage of children in the County served by First 5 

According to the 2011 population estimates for Santa Cruz County, there are approximately 21,258 

children ages 0‐5 residing in the county. 9 

� Funded partners served 9,292 unique children, or over two‐fifths of all children in the county 

(44%), during the 2010‐2011 year. 

� Among the Latino population, 62% of all children ages 0‐5 participated in services funded by 

First 5. 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

Figure 17: Percentage of Children 0-5 in Santa Cruz County Served by First 5 

31% 30% 

23% 

35% 

Sources: Population figures are for calendar years, taken from State of California, Department of Finance, Race/Ethnic Population with Age and Sex 

Detail, 2000–2050. Sacramento, CA, July 2007‐2011. Client counts are for fiscal years, taken from SUN database/CCD data, July 1, 2006 – June 30, 

2011. 

It is important to note that the percentage of children served in the county is actually higher if one 

includes children who were indirectly supported by a First 5‐funded program, such as children 

whose child care providers received professional training through funded partner programs, 

children whose parents received a Kit for New Parents or attended a parent workshop, and children 

benefiting from service providers who attended brown bags and customer service trainings. 

9 State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail, 2000–2050. Sacramento, CA, 2011. 

41% 

27% 26% 27% 


62% 

44% 


Percent of SCC Latino Children 0‐5 

Served by First 5 

Percent of SCC Children 0‐5 Served 

by First 5


Increase Services into Communities with the Highest Needs 

Indicator: Demographic Trends in Children participating in First 5 Programs 



As can be seen in the following figure, over the past four years funded partners have consistently 

served Latino and Spanish‐speaking children, children who reside in South County, and children 

from low‐income backgrounds. Across the years, at least three‐fourths of families served lived 

below the Federal Poverty Level, and beginning in 2009‐10, around 90% of families have had 

incomes below this level. 

Figure 18: Demographics of Children Participating in First 5 Programs, by Year 

100% 

80% 

60% 

40% 

20% 

0% 

86.6% 

81.7% 83.0% 85.1% 

74.9% 80.5% 

73.7% 74.4% 70.6% 

75.2% 

65.8% 

54.9% 

Latino Spanish as Primary 

Language 

2007‐08 2008‐09 2009‐10 2010‐11 

Source: (Latino, Spanish, South County, Income) SUN database/CCD data for July 1, 2007 – June 30, 2011. (Federal Poverty Level for family of five) U.S. 

Department of Health and Human Services, 2011 HHS Federal Poverty Guidelines. 

2007‐2008 data: N for Ethnicity = 4,235; N for Spanish = 4,192; N for Federal Poverty Level (FPL) = 1,346; N for Region of County = 5,214. 2008‐2009 

data: N for Ethnicity = 4,968; N for Spanish = 4,896; N for FPL = 1,113; N for Region of County = 5,440. 2009‐2010 data: N for Ethnicity = 5,620; N for 

Spanish = 5,563; N for FPL = 537; N for Region of County = 5,276. 2010‐2011 data: N for Ethnicity = 8,848; N for Spanish = 9,086; N for Region of 

County = 8,932; N for FPL = 561. 

The following figure presents participant income data, and compares these data with the 

2011 Federal Poverty Level (FPL) and the 2008 Santa Cruz County Self‐Sufficiency Standard. 10 

Drawing from previous First 5 data, an average family size of five persons is used in these 

comparisons. The income thresholds are as follows: 

� The 2011 Federal Poverty Level for a family of five was $26,170. Data show that 89% of the 

families served by First 5 in 2010‐11 earned less than $25,000 per year. 

� The 2008 Santa Cruz County Self‐Sufficiency Standard for a family of five was $86,566. Data 

show that 99.6% of First 5 families in 2010‐11 earned less than $75,000 a year. 

10 2008 is the most recent year for which the Santa Cruz County Self‐Sufficiency Standard is available. 

91.8% 

78.2% 

88.8% 

78.0% 

South County Below Federal Poverty 

Line 

Indicator: Percentage of First 5 families with incomes below the County Self‐Sufficiency 

Standard / Federal Poverty Levels 

31



As seen in the following figure, these data suggest that families being served have very limited 

financial resources, and that First 5 is targeting their services toward the families most in need. 

Figure 19: Annual Family Income of Parents Participating in First 5 Programs, 2010-11 

50% 

40% 

30% 

20% 

10% 

0% 

34.4% 

22.6% 

17.6% 

14.1% 

4.5% 5.0% 

Sources: (Income) SUN database/CCD data for July 1, 2010 – June 30, 2011. N=561. (Federal Poverty Level) U.S. Department of Health and Human 

Services, 2011 HHS Federal Poverty Guidelines. (California Self‐Sufficiency Standard) Insight Center for Community Economic Development, California 

Family Economic Self‐Sufficiency Standard by County, 2008. 

Note: Families with unknown income, or who declined to answer, were omitted from this analysis. N=561. While not all programs collect income data 

from families, these results are considered to be representative of the First 5 client population. 

The following figure presents the percentage of First 5 families below the federal poverty and self 

sufficiency thresholds over time. As seen below, First 5 is reaching an increasingly low income 

population. 

Figure 20: Percentage of First 5 Families with Income below Poverty and Self- 

Sufficiency Thresholds, by Year 

100% 

80% 

60% 

40% 

Less than 

$10,000 

71.6% 

$10,000 ‐ 

$14,999 

90.5% 

$15,000 ‐ 

$19,999 

$20,000 ‐ 

$24,999 

94.9% 95.3% 

78.2% 78.0% 

2011 Federal Poverty 

Level for a family or 

household of 5: 

$26,170 

$25,000 ‐ 

$29,999 

$30,000‐ 

$39,999 

Sources: (Income) SUN database/CCD data for July 1, 2010 – June 30, 2011. N=561. (Federal Poverty Level) U.S. Department of Health and Human 

Services, 2011 HHS Federal Poverty Guidelines. (California Self‐Sufficiency Standard) Insight Center for Community Economic Development, California 

Family Economic Self‐Sufficiency Standard by County, 2008. 

Note: While not all programs collect income data from families, these results are considered to be representative of the First 5 client population. 


0.4% 

$40,000 ‐ 

$49,000 

99.5% 99.6% 

91.8% 

88.8% 


2008 Santa Cruz County 

Self‐Sufficiency Standard 

for a family of 5: 

$86,566 

1.1% 

$50,000 ‐ 

$74,999 

0.0% 

$75,000 ‐ 

$99,999 

0.4% 

$100,000 or 

more 

Percent with 

Incomes Below the 

Federal Poverty 

Level 

Percent with 

Incomes Below the 


Self‐Sufficiency 

Standard


Indicator: Levels of children’s vulnerability in Santa Cruz County, by ZIP code 



In a 2005 assessment of the levels of children’s vulnerability within Santa Cruz County, 10 indicators 

of risk were measured and tracked by ZIP code within Santa Cruz County: income relative to the 

Federal Poverty Threshold, self‐sufficiency, Medi‐Cal births, parental unemployment, births to 

teens, referrals to child welfare services, child abuse, child witnesses to domestic violence, adults 

without a high school degree, and linguistic isolation. For each indicator, one of four levels of risk 

was assigned. 

In the following map, the combined risk of these 10 indicators has been determined and displayed 

for each ZIP code to illustrate the areas of highest vulnerability for children ages 0‐5 in Santa Cruz 

County. In addition to the combined risk for each ZIP code, dots indicate if the ZIP code had a school 

that had an Academic Performance Index (API) score of 3 or lower. 

Figure 21: Levels of Children’s Vulnerability in Santa Cruz County, by ZIP code 

Source: Applied Survey Research, Geo‐Mapping Children’s Vulnerability in Santa Cruz County, Presentation to First 5 Santa Cruz County, 2005. 

In order to determine whether First 5 partners are serving children in the highest need areas of the 

county, a second map displays the relative size of client populations, with darker colors indicating 

more First 5 participants served than lighter colors. As seen in the following figure, 92% of children 

served by funded partners lived in the areas of the county that ranked highest on a cumulative index 

33



of risk factors (such as the Live Oak area of Santa Cruz, the city of Santa Cruz, Watsonville and 

Freedom), showing that First 5 partners are reaching the most vulnerable children. 

Figure 22: Distribution of Children Who Received Services (2010-11), by ZIP Code 

Figure 23: Number of Children Who Received Services, by ZIP Code 

AREA ZIP CODE 

NUMBER OF 

CHILDREN 

SERVED 

AREA ZIP CODE 

NUMBER OF 

CHILDREN 

SERVED 

Aptos, Rio Del Mar 95003 127 Mt. Hermon 95041 5 

Ben Lomond 95005 48 Santa Cruz* 95060 692 

Boulder Creek 95006 56 Santa Cruz (Live Oak) 95062 753 

Brookdale 95007 5 Santa Cruz 95064 16 

Capitola 95010 98 Santa Cruz 95065 77 

Davenport 95017 23 Scotts Valley 95066 58 

Felton 95018 84 Soquel 95073 68 

Freedom 95019 466 Watsonville 95076 6,124 

Total ‐ 8,700 

Source: SUN database/CCD data for July 1, 2010 – June 30, 2011. 

Note. First 5 programs served 9,292 children. The charts above display data for the 8,700 children with known ZIP codes. 

* 8 children with Santa Cruz Post Office mailing addresses were included in this area. 



Early Childhood Educators Served by First 5 Partners 



First 5 Santa Cruz County helps support the professional development of early childhood educators 

in the community. In 2010‐11, approximately 125 early childhood educators were served, 

representing preschools, family child care homes, or informal care providers who were family, 

friends or neighbors (FFN). 

There were additional early childhood educators who received services—who were not included in 

this official CCD database—which would raise the total number served in 2010‐11. For Raising A 

Reader, just one early childhood educator per site is counted, when in fact each site may have 

several early childhood educators participating in the program. 

Figure 24: Early Childhood Educators Served by First 5, by Type 

100% 

80% 

60% 

40% 

20% 

0% 

65.3% 

28.0% 


5.1% 

Early Childhood Educators (N = 118) 

Preschool/Child Care Center 

Family Child Care Home 

Family, Friend, or Neighbor/Informal Care Provider 

Other 

1.7% 

35





Healthy Children HEALTHY CHILDREN 


HEALTHY CHILDREN 

This portion of First 5 Santa Cruz County’s Strategic Framework 

analysis includes data regarding the current estimates of children 

without health insurance, enrollment outcomes from the Healthy Kids 

Initiative’s Health Care Outreach Coalition, results from the Newborn 

Enrollment Project, and health insurance utilization and reenrollment 

data. Additional information about partners’ efforts to support Healthy Children can be found in the 

Partner Profiles section of this report. 

Increase Insurance Coverage 

Indicator: Percentage of children in Santa Cruz County with health insurance coverage 

In Santa Cruz County the majority of children ages 0‐5 have health insurance. CHIS data show that in 

2009, approximately 93% of all children ages 0‐5 had health insurance. During this continuing period 

of economic instability, it is especially important to continue providing assistance to families to 

enroll in public health insurance programs, to ensure that every child ages 0‐5 is insured. 

Figure 25: Percentage of Children ages 0-5 in Santa Cruz County Estimated to be 

Insured 

100% 

95% 

90% 

85% 

80% 

93.9% 

96.2% 

93.3% 

2001 2005 2009 

Source: California Health Interview Surveys. 

Note: CHIS data are released every two years. Data for 2011 will not be available until late 2012. CHIS reports these results as being “statistically 

unstable,” and should only be considered as estimates of the percentage of uninsured children. 

37



Indicator: Number of children participating in First 5 who have applications submitted, 

accepted, and renewed for publicly‐funded health insurance 

Public health insurance programs are essential to the overall health and well‐being of children. The 

Health Care Outreach Coalition (HCOC) provides assistance with application and enrollment in public 

health insurance to income‐eligible families. Through community outreach workers called Certified 

Application Assistors (CAAs), children from families earning up to 300% of 

the Federal Poverty Level receive assistance in applying for Medi‐Cal, 

Healthy Families, and the local Healthy Kids health insurance plan. 

Additionally, HCOC staff participate in community events and respond to 

business and community agency requests for presentations and additional 

information regarding health insurance. 

Children newly enrolled 

in public health 

insurance since 2004: 

7, ,488 

The following figures present the number of applications approved (applicant becomes enrolled in 

health insurance), and number of enrollees who renew their health insurance. Across the years 

since the effort began in 2004, 7,488 children have been enrolled in public health insurance. 11 The 

large increase in Medi‐Cal enrollments in 2009‐10 is due to the Newborn Enrollment Project, 

described subsequently. 

Figure 26: Children (Ages 0-5) Newly Enrolled by HCOC in Healthy Kids, Healthy 

Families and Medi-Cal insurance plans 

2,000 

1,800 

1,600 

1,400 

1,200 

1,000 

800 

600 

400 

200 

0 

580 

519 

352 359 

Source: Health Care Outreach Coalition, County Benefits Tracking Report, 2010; Health Care Outreach Coalition, Newborn Enrollment Statistics, 2011. 

Note: These numbers are from Certified Application Assisters who expand enrollment and retention efforts in the County. Many families are enrolled 

in other ways. For example, the County Human Services Department processes Medi‐Cal applications which are not included here, and families can 

self‐enroll in Healthy Families. 

Note: The number of children in this analysis may be slightly different than related enrollment results from HCOC due to differences in the timing of 

the collection of data. and since families may come to HCOC for enrollment assistance more than once in the fiscal year. 

11 Health Improvement Partnership of Santa Cruz County, 2011. 

620 

395 

175 

118 

158 

53 42 67 

1,312 

1,741 

96 70 


901 

315 

1,226 

445 


Total (Healthy Kids, Healthy 

Families & Medi‐Cal) 

Healthy Kids 

Healthy Families 

Medi‐Cal




Figure 27: Number of Children (Ages 0-5) in Santa Cruz County Re-Enrolled in Publicly- 

Funded Health Insurance Programs, by Year 

600 

500 

400 

300 

200 

100 

0 

257 

181 

27 

318 

182 

19 

411 

131 

40 

Source: Health Care Outreach Coalition, County Benefits Tracking Report, 2010; Health Care Outreach Coalition, Newborn Enrollment Statistics, 2011. 

Note: These numbers are from Certified Application Assisters who expand enrollment and retention efforts in the County. Many families are enrolled 

in other ways. For example, the County Human Services Department processes Medi‐Cal applications which are not included here, and families can 

self‐enroll in Healthy Families. 

Note: The number of children in this analysis may be slightly different than related enrollment results from HCOC due to differences in the timing of 

the collection of data. and since families may come to HCOC for enrollment assistance more than once in the fiscal year. 

Baby Gateway—the Newborn Enrollment Project—has now been launched in three local hospitals 

with funding and support provided by First 5 of Santa Cruz County: Watsonville Hospital (in August 

2009), Dominican Hospital (in January 2011), and Sutter Maternity & Surgery Center of Santa Cruz (in 

May 2011). The main goals of the project are to provide enrollment assistance to mothers and their 

newborns, as well as to establish a seamless Medi‐Cal coverage process for Medi‐Cal‐eligible 

newborns, and to link those newborns to a medical home, all before they leave the hospital. 

In addition, all new mothers receive the First 5 “Kit for New Parents” containing expert guidance for 

raising healthy infants and children. In particular, parents are oriented to the “What To Do If My Child 

Gets Sick” booklet, which provides information in utilizing primary care appropriately, and clarifies 

what issues should prompt a visit to the emergency room (and which should be handled in the medical 

home). 

487 

150 

139 

442 

269 

120 


Healthy Kids 

Healthy Families 

Medi‐Cal/Medicare 

Indicator: Number of mothers in the County visited as part of the Newborn Enrollment 

Project 

39



Data from 2010‐11 show how successful this program has been in providing these services to Santa 

Cruz County’s mothers and newborns. 

� Of all 2,103 births that occurred in Santa Cruz County at these hospitals after the program 

had been implemented, 70% of mothers received a newborn visit while in the hospital, and 

65% received a “Kit for New Parents.” 

� Of all 1,499 mothers with Medi‐Cal births during 2010‐11, almost three‐fourths (74%) were 

assisted to complete a Medi‐Cal application for their new babies. 

� Of the 1,111 mothers who were assisted to complete a Medi‐Cal application for their 

newborns, nearly all applications (95%) were approved, and 97% were assigned a primary 

care provider for their child before discharge from the hospital. 

Figure 28: Newborn Enrollment Project Statistics, 2010-11 

PROGRAM COMPONENT WATSONVILLE 

Total Number of All Births in Santa Cruz 

County after program implementation 

COMMUNITY 

HOSPITAL 

DOMINICAN 

HOSPITAL 1 

SUTTER 

MATERNITY & 

SURGERY CENTER 

OF SANTA CRUZ 2 

1,487 437 179 2,103 

Total Number of Medi‐Cal Births 1,247 191 61 1,499 

Number of Completed Newborn 

Medi‐Cal Applications 

Number of Approved Newborn 

Medi‐Cal Enrollments 

Number of Denied Newborn 


Number of Pending Newborn 


Number of Newborn Medi‐Cal 

Applicants with an Assigned 

Primary Care Provider 

Total Number of Newborn Visits 

(regardless of insurance status) 

Number of Kits for New Parents 

Distributed 

Source: Health Care Outreach Coalition, Newborn Enrollment Statistics, 2011. 

1 Based on program implementation of 1/10/11. 



TOTAL 

NUMBER PERCENT OF ALL 

MEDI‐CAL BIRTHS 

919 141 51 1,111 74.1% 


MEDI‐CAL 

APPLICATIONS 

883 133 44 1,060 95.4% 

21 1 0 22 2.0% 

15 7 7 29 2.6% 

1,074 96.7% 


COUNTY BIRTHS 

1,040 289 136 1,465 69.7% 

1,040 184 136 1,360 64.7%


Increase Use of Medical/Dental Homes 



Indicator: Percentage of children in the County enrolled in Healthy Kids (ages 2‐6) who 

had access to a primary care practitioner 

The majority of children enrolled in Healthy Kids, ages 2‐6, had access to a primary care practitioner. 

The percentage of children who had a medical home has varied between 90% in 2006 to 95% in 

2010. 

Figure 29: Percentage of Children in the County Enrolled in Healthy Kids (Ages 2-6) 

Who Had Access to a Primary Care Practitioner 

100% 

90% 

80% 

70% 

60% 

50% 

89.9% 

2006 

(N = 227) 

90.1% 

2007 

(N = 221) 

93.8% 

2008 

(N = 227) 

Source: Central Coast Alliance for Health, Health Care Quality Measurement annual report, using HEDIS Indicators. There are no HEDIS data regarding 

access to primary care practitioners for children under age one. For children age one, there were not enough children in the HEDIS sample to draw 

any inferences. 

Parents of children receiving First 5‐funded services through the Health Care Outreach Coalition 

were asked when they renewed their children’s insurance whether their children had used the 

benefit during the previous year. During the 2010‐2011 year, 97% of children who received renewal 

assistance in a public insurance program utilized their benefits prior to their renewal, continuing the 

trend of high utilization across the years. 

89.4% 

2009 

(N = 208) 

95.1% 

2010 

(N = 164) 

Indicator: Percentage of children utilizing health care prior to renewal in an insurance 

program 

Figure 30: Percentage of Parents Reporting their Children Utilized Health Care Prior to 

Renewal in an Insurance Program 

100% 

90% 

80% 

70% 

60% 

50% 

99.6% 97.9% 

2006‐07 

(N = 471) 

2007‐08 

(N = 514) 

99.6% 99.4% 

2008‐09 

(N = 555) 

2009‐10 

(N = 789) 

96.6% 

2010‐11 

(N = 829) 

Source: Health Care Outreach Coalition, Annual Progress Report, 2007‐2011. Results represent the status of children’s applications 2‐3 months after 

the end of the fiscal year. Utilization results exclude clients with missing data. 

41



Indicator: Percentage of children in the County enrolled in Healthy Kids who had a 

dental visit in the past year 

Of children ages 4‐6 enrolled in Healthy Kids in 2010, the majority (89%) had a dental visit in the past 

year. This percentage has been slowly increasing since 2006 (69%). A smaller percentage of younger 

children (ages 2‐3) are getting dental visits, although this too has been increasing between 2006 

(49%) and 2010 (69%). 

Figure 31: Percentage of Children in the County Enrolled in Healthy Kids Who Had a 

Dental Visit in the Past Year 

100% 

80% 

60% 

40% 

20% 

0% 

48.9% 

68.7% 

54.8% 

70.6% 

61.4% 

79.2% 

Source: Central Coast Alliance for Health, Health Care Quality Measurement annual report, using HEDIS Indicators. 

* No data are available for 2009. 

Children ages 2‐3 N: 2006=45, 2007=42, 2008=44, 2010=32; Children ages 4‐6 N: 2006=182, 2007=180, 2008=183, 2010=132, 

Increase Use of Preventive Health Services 

In 2010, the majority of children ages 3‐6 (83%) enrolled in Healthy Kids received a well‐child visit 

with their pediatrician, showing a slight increase over the past three years. 

Figure 32: Percentage of Children (Ages 3-6) in the County Enrolled in Healthy Kids 

Who Received a Well-Child Visit 

85% 

80% 

75% 

70% 

78.1% 

2006 

(N = 210) 

Source: Central Coast Alliance for Health, Health Care Quality Measurement annual report, using HEDIS Indicators. 

68.8% 

2006 2007 2008 2009* 2010 

81.6% 

2007 

(N = 207) 

Children ages 2‐3 Children ages 4‐6 

76.8% 

2008 

(N = 211) 

79.6% 

2009 

(N = 191) 

82.9% 


(N = 152) 

89.4% 

Indicator: Percentage of children in the County enrolled in Healthy Kids (ages 3‐6) who 

received a well‐child visit 





Ideally, children and their families who have insurance and who have a medical home will be more 

likely to access their provider for routine preventive care, and less likely to use the emergency 

department (ED) for non‐urgent medical care. The figure below presents data on children enrolled 

in Santa Cruz County’s Healthy Kids program regarding the rate at which they used the emergency 

room each year. These data are not available in disaggregated form for children 0‐5, and therefore 

includes children up to age 9. The rate of ED use for children using Healthy Kids insurance was 

increasing up through 2008, but has shown a decrease since 2009. 

Figure 33: Visits to Emergency Department in the Past Year, per 1,000 Member Year 

(Ages 1-9) 

300 

250 

200 

150 

100 

161.4 

229.7 

266.2 265.9 

Source: Central California Alliance for Health, Health Care Quality Measurement annual report, using Healthcare Effectiveness Data and Information 

System (HEDIS) indicators. 

Note: Data represent only children enrolled in Healthy Kids. 

The services provided by the Newborn Enrollment Project may also have had an effect on the use of 

the Emergency Department (ED) for children less than one year old. As seen in the following figure, 

ED visits at Watsonville Community Hospital were at a high of 632 in the 2 nd quarter of 2009. Baby 

Gateway was launched at that hospital in August 2009, and after that the number of ED visits has 

dropped steadily to a low of 424 at the beginning of 2011. 

Figure 34: Number of Emergency Department Visits (Infants Less Than One Year Old) 

700 

600 

500 

400 

300 

200 

100 

0 

573 

2006 

(N=133) 

218 

632 

Baby Gateway 

Launched 8/2009 

184 

2007 

(N=185) 

552 558 

151 

171 

2008 

(N=178) 

2009 

(N=190) 

Source: Health Improvement Partnership of Santa Cruz County, Baby Gateway Program Report, August 16, 2011. 

506 

199 

528 

146 

471 


421 424 

168 

186 

Baby Gateway 

Launched 1/2011 

Q1/2009 Q2/09 Q3/09 Q4/09 Q1/2010 Q2/10 Q3/10 Q4/10 Q1/2011 

214.4 


(N=119) 

Watsonville Community Hospital 

Dominican Hospital 

43






Strong Families STRONG FAMILIES 


STRONG FAMILIES 

This portion of First 5 Santa Cruz County’s Strategic Framework analysis 

includes data regarding the need to reduce the County’s rate of child 

maltreatment, outcomes for families served by the county’s differential 

response effort (Families Together), and outcomes for clients participating in the Positive Parenting 

Program (Triple P). Additional information about partners’ efforts to support Strong Families can be 

found in the Partner Profiles section of this report. 

Decrease Child Abuse and Neglect 

Indicator: Rate of substantiated allegations of child maltreatment in the County 

The rate of substantiated allegations of child maltreatment in Santa Cruz County has decreased from 

a high of 15.8 (per 1,000) in 2004, to 7.6 (per 1,000) in 2010. In 2010, the county rate dropped lower 

than the state‐wide rate of substantiated allegations of child maltreatment for the first time in 

reporting history. The decreasing rates in Santa Cruz County may have been assisted by the efforts 

of the Families Together program, which launched in late 2006 (see the following results for 

additional information about this program). 

Figure 35: Rate of Substantiated Allegations of Child Maltreatment in Santa Cruz 

County and California (per 1,000) 

18 

16 

14 

12 

10 

8 

6 

4 

2 

0 

15.8 

15.3 

13.5 

14.7 

11.2 11.0 10.8 10.7 

Families Together 


12.4 

2004 2005 2006 2007 2008 2009 2010 

9.7 

Source: Needell, B., Webster, D., Armijo, M., Lee, S., Dawson, W., Magruder, J., Exel, M., Cuccaro‐Alamin, S., Putnam‐Hornstein, E., Williams, D., 

Simon, V., Hamilton, D., Lou, C., Peng, C., Moore, M., Jacobs, L., & King, B. (2011). Child Welfare Services Reports for California. Retrieved 8/1/2011, 

from University of California at Berkeley Center for Social Services Research website. URL: 

Note: The rates for each year are calculated based on reports from January 1 to December 31 of each year. 

9.6 

9.3 

8.7 

7.6 


California 

45



Indicator: Percentage of Families Together participants at each level of risk, baseline to 

reassessment 

Families Together is Santa Cruz County’s differential response program, a strategy used to intervene 

early with families in which there has been an allegation of abuse. This home visiting program 

includes comprehensive intake and risk assessment, development of a tailored case plan, parent 

support and education, child development activities, and periodic assessments. 

In Families Together, risk assessment serves a variety of purposes. First, the assessments help staff 

link parents with the appropriate service pathway, including Brief services, Intensive services, and 

referrals to Primeros Pasos, a program for parents struggling with alcohol and drug dependency. 

Follow‐up assessments help assess whether risk for child abuse and neglect has been reduced. 

The following figure presents the percentage of families at each level of risk over four assessments 

(baseline, and first, second, and third reassessments). Each year’s analysis is constrained by fairly 

small sample sizes. Therefore, several years of data have been aggregated in order to present a 

more robust portrait of the extent to which Families Together participants are reducing their risk for 

future involvement with the child welfare system. As can be seen, 62% of families were assessed as 

being high risk or very high risk upon intake, and this dropped to 13% by the third reassessment, 

indicating that the program is helping families reduce their level of risk. 

Figure 36: Change in Families Together Participant’s Risk Levels Over Time, 

2007 - 2011 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

44.7% 

38.4% 

Baseline* 

(N = 237) 

16.9% 

28.1% 

49.7% 

20.0% 

1st Reassessment 

(N = 185) 

2.2% 

29.4% 

51.5% 

14.7% 

26.7% 

60.0% 

13.3% 

Source: SUN database, Structured Decision Making: Family Prevention Services Screening Tool (SDM:FPSST) data, 2007‐2011. 

* Although very few families had a “low risk” score at baseline, these families were omitted from these analyses so that only those who could 

demonstrate reduced risk on the tool remained in the analysis. 

Note: Due to inaccuracies in data entry in 2006‐07, clients with baseline assessments before 7/1/07 were omitted from this analysis. 


4.4% 

2nd Reassessment 

(N = 68) 

0.0% 

3rd Reassessment 

(N=15) 

Low Risk 

Moderate Risk 

High Risk 

Very High Risk




Indicator: Percentage of Families Together participants with substantiated allegations 

of child maltreatment within 6 months of program completion 

Of the 82 families who received services from Families Together and had their cases closed in the 

2010 calendar year, 96% had no substantiated allegations of maltreatment within six months after 

case closure. 

Figure 37: Number of Families Together Families who had Substantated Allegations of 

Abuse within 6 Months after Completing the Program 

Total number of families served, with cases closed during 

the 2010 calendar year 

Number of families with substantiated allegations of 

child abuse or neglect within 6 months after their 

Families Together closure date 

Total number and percent of families served who did 

not have a subsequent substantiated allegation of 

child abuse within 6 months of case closure 

NUMBER PERCENT 

82 100% 

3 3.7% 

79 96.3% 

Source: Santa Cruz County Human Services Department, Planning and Evaluation Unit. Staff analysis of CWS/CMS data, 2011. 

Indicator: Percentage of Triple P participants in the Child Welfare system with 

substantiated allegations of child maltreatment within 6 months of program 

completion 

Among families who have experienced child abuse or neglect, participation in the Triple P program 12 

was expected to be associated with lower rates of future child welfare allegations. To examine 

whether associations were observed between Triple P participation and improved child welfare 

outcomes in these Santa Cruz County families, outcome data for two groups of parents who entered 

(or re‐entered) the child welfare system were compared, including: (1) parents who received the 

Triple P intervention; and (2) parents who were enrolled in a model of parenting education offered 

prior to the initiation of the Triple P program. Both programs were offered through a local 

community‐based organization called the Parents Center. 

12 For a detailed description of this program, see “Triple P – Positive Parenting Program” in the Partner Profile section. 

47



Results suggest that Triple P is associated with reductions in future child abuse and neglect. 

� After six months, parents in the comparison parenting program were more than three and a 

half times more likely than Triple P participants to have had a new substantiated 

maltreatment allegation. 

Figure 38: Participants with a Substantiated Allegation of Child Maltreatment Occurring 

Up to 6 Months after Program Entry 

20% 

15% 

10% 

5% 

0% 

1.4% 

Source: Applied Survey Research, Triple P – Santa Cruz County: Special Exploratory Study to Assess Child Welfare Outcomes, 2011. 

N: 70 Triple P participants and 137 comparison group participants. 

Improve Parent and Caregiver Practices that Support Children’s 

Social and Emotional Development 

The Triple P Program 

5.1% 

Triple P Participants Comparison Group 

Triple P (Positive Parenting Program) is a comprehensive, evidence‐based parenting and family 

support system designed to increase parents’ confidence and competence in raising children, 

improve the quality of parent‐child relationships, and make evidence‐based parenting information 

and interventions widely accessible to parents. It is based on a public health model in which an 

ecological approach is used. This approach initiates activities at individual, family, community, and 

systemic levels to provide a comprehensive structure of support. There are five levels of 

intervention in Triple P. Level 1 is intended to reach a broad range of community members in the 

County, and as the levels increase, more intensive services are provided. 





Triple P focuses on 17 core parenting skills that are grouped into 4 areas: promoting positive 

relationships, encouraging desirable behavior, teaching new skills and behaviors, and managing 

misbehavior. It is based on a self‐regulatory framework in which the practitioner provides 

information, skills, training, and support based on the parents’ concerns. Parents use self‐evaluation 

to set goals and assess progress. While practitioners are helping parents to build confidence and 

competence, parents are helping children to build these skills in a parallel process. 

Figure 39: The 17 Core Parenting Skills Promoted by Triple P 

Developing Positive 

Relationships 

Encouraging Desirable 

Behaviors 

Teaching New Skills & 

Behaviors 

Managing Misbehavior 

1. Spending quality time with your child 

2. Talking to your child 

3. Showing affection to your child 

4. Using descriptive praise 

5. Giving attention 

6. Providing engaging activities 

7. Setting a good example 

8. Using incidental teaching 

9. Using Ask, Say, Do 

10. Using behavior charts 

11. Setting ground rules 

12. Directed discussion 

13. Planned ignoring 

14. Clear, calm instructions 

15. Logical consequences 

16. Quiet Time 

17. Time Out 

Implementation of the Triple P Program in Santa Cruz County 

Beginning in early 2010, three local funders (First 5 Santa Cruz County, Health Services Agency, and 

Human Services Department) launched a pilot of the Triple P system in partnership with other 

agencies that serve children and families. The pilot phase was designed to last two years. During this 

pilot phase, Triple P has been implemented incrementally, beginning with Levels 3, 4, and 5 in the 

first year, and adding Levels 1 and 2 in this second year. The long‐term vision is to implement every 

level of Triple P broadly in Santa Cruz County to make parenting information and support available 

to all families. 

49



Indicator: Improved parenting skills, knowledge, and support 

The following diagram illustrates the design of this program, and the results that have been achieved 

towards addressing the program’s incremental levels of parenting support and information. 

Level 5: Enhanced & Pathways 

Additional support for families where parenting issues are compounded by parental stress and/or relationship 

difficulties, or there is risk for child maltreatment. 

Implementation and Results in Santa Cruz County 

� Trained and accredited 18 practitioners to provide Level 5 Enhanced services, and 18 for Level 5 Pathways. 

� Parents are beginning to receive Level 5 services, and will complete assessments to measure improvement 

in their parenting skills and understanding of their children’s behavior. 

Level 4: Standard & Group 

In-depth training in positive parenting skills. 


� Families showed significant improvements in: 

– style of discipline – confidence in their parenting – levels of conflict over parenting – level of satisfaction with 

their relationship – levels of parental depression – stress and anxiety – child behavior 

� Parents who had more serious parenting issues made the most meaningful changes in their family life. 

� Parents reported high levels of satisfaction with their services. 

� Approximately 282 parents/guardians have participated in Level 4 sessions. 

� Trained and accredited 38 practitioners to provide Level 4 Group services, and 37 for Level 4 Standard. 

Level 3: Primary Care 

Consultations about specific parenting concerns. 


� Families showed significant improvements in children’s behavior, confidence in parenting skills, and support from parenting 

partners. 

� Parents reported high levels of satisfaction with both Level 3 workshops and individual/group sessions. 

� Approximately 336 parents have participated in Level 3 workshops, and 35 in Level 3 Individual/Group sessions. 

� Trained and accredited 53 practitioners to provide Level 3 Primary Care services, and 5 with Special Accreditation in Level 3. 

Level 2: Selected Individual & Seminar 

General information and tips for specific parenting concerns. 


� Parents reported great satisfaction with Level 2 seminars, particularly noting that they would continue to use the strategies that they learned. 

� Approximately 96 parents have participated in Level 2 seminars, and 104 in Level 2 Individual sessions. 

� Trained and accredited 20 practitioners to provide Level 2 seminars, and 53 for Level 2 Individual sessions. 

Level 1: Universal 

Media-based parenting information campaign. 


� Enhanced First 5’s website to include information about Triple P, accredited practitioners, referral processes, and a master calendar of Triple P Groups, 

Workshops, and Seminars. 

� Disseminated flyers and descriptions of Triple P Seminars, Workshops, and Groups to service providers as a means to encourage referrals. 

� Publicized Triple P services in print and online editions of newspapers and community calendars. 

� Established First 5’s main phone number as a “warmline,” publicized in all flyers, emails and media announcements as a central place to locate services. 

� Delivered Triple P messages on TV and the radio. 





Selected data are highlighted below for their significance, and more detailed data are presented in 

the Triple P Partner Profile found later in this report. 

Indicator: Use of positive discipline styles 

Parents who participated in Level 4 of the Triple P program were asked to complete the Parenting Scale 

as a pre and post assessment of their style of discipline. Scores could range from 1 (positive parenting) to 

7 (ineffective parenting), with lower scores indicating more positive styles of discipline. Analyses were 

run to see if there was any improvement between pre and post assessments, and if the amount of 

improvement was statistically significant. 13 

As seen in the figure below, 

Dysfunctional 

Parenting 

7 

6 

Lower 5 

is 

“Better” 

4 

3 

2 

1 

Functional 

Parenting 

� There was significant improvement from pre to post assessment regarding parents’ style of 

discipline, indicating their parenting style became less lax, less over‐reactive, and less hostile 

though the course of the Triple P program. 

� When looking at overall scores on the Parenting Scale, on average, all parents combined and 

all parent sub‐populations that were assessed began in the clinical range, but had achieved 

positive styles of discipline by the post‐assessment. 

� An analysis of “Effect Size” (see page 103) showed that on average, all parent 

sub‐populations experienced a large magnitude of change, indicating that the observed 

differences were not only statistically significant but also meaningful. 

Figure 40: Parents’ Use of Positive Discipline Styles 

Overall 

3.3 3.8 3.6 3.8 3.8 3.7 3.9 3.7 3.7 

2.7 2.9 3.0 2.9 3.0 2.9 3.0 2.9 3.0 

All Parents* 

(N=158) 

Clinical 

Range at 

PreTest* 

(N=86) 

Male* 

(N=20) 

Female* 

(N=66) 

Pre Post 

Latino* 

(N=61) 

Caucasian* 

(N=21) 

Spanish* 

(N=44) 

English* 

(N=37) 

Child Welfare 

Involved* 

(N=30) 

Source: Triple P data from the Parenting Scale, collected and analyzed by Applied Survey Research, 2011. 

Note: The Parenting Scale measures parenting styles in 3 scales, and overall. Scores for each scale are calculated by averaging the participants’ 

responses for each of the items. Higher scores indicate a greater degree of ineffective parenting styles. See page 102 for a description of the 

sub‐populations and analyses that were run. 

* Results marked with an asterisk had PRE/POST differences that were statistically significant at p= 3.2 

51



In Triple P, the parent is considered the agent of change to bring about improvements in the parent‐ 

child relationship. Therefore, how parents view their children’s behavior is an important assessment 

of the relationship. 

Parents participating in Level 4 of the Triple P Program were asked to complete the Eyberg Child 

Behavior Inventory (ECBI), a pre and post assessment that includes an assessment of the extent to 

which parents viewed certain child behaviors to be a problem in their family. Scores ranged from 0 

(No) to 36 (Yes), with higher scores indicating greater likelihood that these behaviors were a problem 

to the parent. Analyses were run to see if there was any improvement between pre and post 

assessments, and if the amount of improvement was statistically significant. 14 

As seen in the following figure, after completing the Triple P Program, parents reported fewer child 

behaviors as actually being a problem for them. Key results include: 

All behaviors were 

a problem 

36 

Lower 

is 

“Better” 

Indicator: Report of child behavior problems 

� For all sub‐populations, there was a significant reduction in the number of child behaviors 

that were perceived to be a problem. Almost all parents began with scores within the clinical 

range, and ended with scores that were out of the clinical range. 

� “Effect Sizes” were also calculated on these analyses (see page 103). Results showed that on 

average, parents experienced a large magnitude of change, indicating that the observed 


Figure 41: Level of Parental Problems with Child Behavior 

30 

24 

18 

12 

6 

0 

No behaviors 

were a problem 

15.0 

8.2 

All Parents* 

(N=129) 

23.0 

Clinical 

Range at 

PreTest* 

(N=62) 

Number of Child Behaviors Perceived to Be a Problem 

20.4 

23.5 24.1 

12.6 11.9 12.7 13.0 

Male* (N=9) Female* 

(N=53) 

Pre Post 

Latino* 

(N=44) 

Source: Triple P data from the Eyberg Child Behavior Inventory, collected and analyzed by Applied Survey Research, 2011. 

Note: The Eyberg Child Behavior Inventory measures the frequency with which certain child behaviors occur (Intensity subscale), and the extent to 

which parents view those behaviors to be a problem (Problem subscale). Intensity scores could range from 36 (Never occurs) to 252 (Always occurs), 

and Problem scores ranged from 0 (No) to 36 (Yes), with higher scores indicating greater frequencies of problem behaviors and greater likelihood that 

these behaviors were a problem to the parent. See page 102 for a description of the sub‐populations and analyses that were run. 

* Results marked with an asterisk had PRE/POST differences that were statistically significant at p=15


Follow‐Up Survey 



Parents and guardians who participated in certain Triple P programs were given the option of 

voluntarily participating in a follow‐up phone survey, to help determine the long‐lasting effects of 

these programs on their parenting skills and experiences. 

Results showed that around six months after completing Triple P services, parents were still 

reporting high levels of parenting skills, confidence, and support. Additional survey results indicated 

that parents felt more effective in dealing with their children’s behavior, and report improved child 

behavior overall. 

Not at all Difficult 

5 

Higher 

is 

“Better” 

Indicator: Amount of positive parenting knowledge that is maintained 

Figure 42: Levels of Parenting Difficulty Six Months After Triple P Services 

4 

3 

2 

1 

0 

Extremely Difficult 

3.58 

Q1: Child Behavior 

Problems (N=26) 

4.21 4.23 

Q2: Parental 

Adjustment (N=26)* 

Q3: Parenting 

Confidence (N=26) 

3.62 3.50 

Q4: Parental Support Q5: Partner Support 

(N=26) Over Methods of 

Discipline (N=18) 

Source: Triple P data from the Parenting Experience Survey, collected and analyzed by Applied Survey Research, 2011. 

Note: The Parenting Experience Survey measures issues related to being a parent. Each question is analyzed separately, and correspond to different 

Triple P outcome objectives examined in this report section. For Q1‐6, scores range from 1 to 5. Q7 was not asked in the Follow‐up Survey. Higher 

scores indicate more positive parenting experiences. There are no clinical cut‐offs for this assessment. See page 102 for a description of the 


* Question 2 results are averages of the 5 items in this question. 

3.83 

Q6: Parenting 

Support from 

Partner (N=18) 

53




CHILDREN LEARNING 


Children Learning and Ready for School 

AND READY FOR SCHOOL 


CHILDREN LEARNING AND READY FOR SCHOOL 

This portion of First 5 Santa Cruz County’s Strategic Framework 

analysis includes data regarding the need for children’s literacy 

support, efforts to increase use of quality child care practices to 

support literacy development, and data regarding young children’s 

gains in research‐based predictors of reading success. Additional 

information about partners’ efforts to support Children Learning and Ready for School can be found in the 

Partner Profiles section of this report 

Improve School Readiness Outcomes 

Indicator: Percentage of 3 rd grade students in the County at/above grade level in 

English/Language Arts 

Many studies have demonstrated that third grade reading scores are a bellwether of students’ later 

academic success, in that third grade reading proficiency is linked to students’ likelihood of 

graduating from high school. 

In 2011, 40% of third‐graders in Santa Cruz County scored at or above grade level in English/Language 

Arts (ELA), compared to 46% of students statewide. Results for the past five years show a gradual 

increase in the percentage of students who are scoring at or above grade level. Two county areas of 

historically low performance have shown particularly great improvements in scores, with PVUSD 

increasing from 21% in 2007 to 28% in 2011, and Freedom Elementary increasing from 12% to 28%. 

Figure 43: Percentage of 3 rd Grade Students in the County At / Above Grade Level In 

English/Language Arts 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

37% 

38% 

34% 34% 

21% 20% 

12% 12% 

Source: California Department of Education, STAR Test Results, 2007‐2011. 

44% 44% 46% 

40% 

37% 

25% 24% 

16% 

24% 

40% 

28% 

28% 

2006‐2007 2007‐2008 2008‐2009 2009‐2010 2010‐2011 

California 


PVUSD 

Freedom Elementary 

55



Increase Use of Quality Early Child Care Practices 

California third graders are struggling to become proficient readers. Local and statewide data 

indicate that well over half of third grade children are not reading at proficiency. Because language 

development in the early years is crucial to later reading success, early childhood educators have a 

unique role in influencing reading scores and later educational success. According to a report 

published in the Journal of Education Psychology, early childhood educators play a key role in the 

language development of children from high poverty backgrounds: 

“Language development has a profound effect on young children’s successful transition to 

school and, in particular, on their success in learning to read. Children who arrive in first grade 

with a foundation in pre‐literacy skills and the interest and motivation to learn are better 

prepared to engage in the complex task of learning to read. 

Most children acquire language and pre‐literacy skills through interactions with adults and 

peers who use language in ways that are consistent with the majority culture and correspond 

to the printed word. Unfortunately, many children raised in poverty have limited access to 

opportunities to develop language and literacy skills in such ways. 

As one important illustration, Hart and Risley (1995) reported that by the age of 3, children in 

poverty were already well behind their more affluent peers in their acquisition of vocabulary and 

oral language skills. Snow et al. (1998) also reported that children in poverty lack necessary 

pre‐literacy skills at the beginning of kindergarten. Similar research indicates that socioeconomic 

status is the strongest predictor of performance differences in children at the beginning of the 

first grade and that this gap persists as children progress from elementary to high school.” 15 

With the evidence of limited language and literacy opportunities in low‐income homes, more 

emphasis has been placed on showing early childhood educators how to build language 

opportunities into their daily child care routines, through fun and meaningful instruction. 

Over the past four years, First 5’s Early Literacy Foundations Initiative has addressed this need to 

provide strong literacy and language foundations for young children through several approaches. 

First 5 has implemented the SEEDS of Early Literacy model of skill development and coaching for early 

childhood educators, encouraged family engagement in literacy activities through expansion of the 

Raising A Reader program, supported child assessments for participating state Pre‐K classrooms in 

order to tailor differentiated instruction, and provided other literacy supports for teachers and 

families. 

15 

American Psychological Association (2006). The Effects of a Language and Literacy Intervention on Head Start Children and Teachers. 

Journal of Educational Psychology, 98, (1), 63–74. 





The following indicators present an overview of the Early Literacy Foundation Initiative’s efforts and 

outcomes this year (additional detail is included in the initiative’s Partner Profile later in this report). 

Indicators discussed here include: 

� Number of ECE teachers who completed SEEDS training 

� Number of SEEDS coaches 

� Number of children participating in Raising A Reader 

� Changes in early childhood educators’ practices that promote early literacy (preschool 

classrooms, family child care settings, and infant/toddler care classrooms) 

� Increased early literacy skills of children 

SEEDS of Early Literacy 

The professional development initiative mentioned above follows the SEEDS of Early Literacy curriculum 

that has been researched by the University of Minnesota. Research on the SEEDS model shows that 

teachers trained and coached on the SEEDS Curriculum score significantly higher on the Early 

Language and Literacy Classroom Observation (ELLCO) tool and show greater change over time in 

teaching strategies than teachers without such training. Results also indicate that preschool children 

who were taught by teachers trained in SEEDS entered kindergarten ready to read at higher rates 

than children in non‐SEEDS groups (Lizakowski, 2005). 

The SEEDS Professional Development model consists of training—and providing coaching to—early 

childhood educators on how to effectively integrate research‐based language and literacy strategies 

and materials into their classrooms. Early childhood educators are taught to use the strategies of 

both embedded instruction (planned strategies that occur within the typical routines of the class 

day) and explicit instruction (teacher‐directed activities that emphasize the teaching of a specific 

task), and to create a classroom environment that is designed to target early literacy predictors. 

These predictors of later reading success include: 

� Conversation and Oral Language: The ability to produce or comprehend spoken language 

� Alphabet Knowledge: The ability to visually discriminate the differences between letters 

and say the names and sounds associated with printed letters 

� Book and Print Rules: Refers to what children understand about how books and print work, 

such as left‐right, front‐back, letters, words and that print has meaning 

� Phonological awareness: The ability to detect, manipulate, or analyze the auditory aspects 

of spoken language, including the ability to distinguish or segment words, syllables, rhymes, 

and beginning sounds 

� Vocabulary and Background Knowledge: A collection of words that relate to experiences 

and knowledge that a child has of the world around him/her 

57



The following diagram displays the five essential SEEDS quality interactions and the five predictors of 

literacy. 

Indicator: Number of early childhood educators who complete SEEDS training, and 

number of educators who are SEEDS coaches 

The following figure presents the number of SEEDS coaches, the number of early childhood educators 

who completed SEEDS trainings, and the number of Family, Friend and Neighbor informal providers 

who attended SEEDS workshops, both in 2010‐11, and cumulatively since 2007. 

Figure 44: Number of Early Childhood Educators Who Have Completed SEEDS 

trainings 

EARLY LITERACY FOUNDATIONS THIS FUNDING CYCLE 

Number of SEEDS Quality Coaches providing literacy coaching, literacy 

environmental assessments, and professional development advising 

for SEEDS instruction, fidelity, and integrity during the year 

Number of early childhood educators attending SEEDS of Early Literacy 

Courses 

Number of Family, Friend or Neighbor (FFN) informal child care 

providers attending SEEDS of Early Literacy workshops 

JULY 1, 2010 – 

JUNE 30, 2011 

CUMULATIVE TOTALS 

2007‐2011 

18 41 

77 356 

9 155 

TOTAL (unduplicated) 104 519 

Source: Early Literacy Foundations (ELF) Initiative, 2010‐11. 





The figures below show additional data about Early Childhood Educators and Coaches who have 

been trained between 2007‐2011. 

Figure 45: Number of SEEDS Trained Early Childhood Educators in Licensed 

Programs, by type of classroom (2007-2011) 

State and Federally‐ 

Subsidized Classrooms 

Figure 46: Primary Language of SEEDS Trained Early Childhood Educators in Licensed 

Programs (2007-2011) 

22.2% 

3.1% 

24.7% 

50.0% 

Licensed Family Child Care 

Homes and Private/ Non‐ 

Profit Centers 

English Only 

Spanish Only 

Bilingual English/Spanish 

Figure 47: Educational Attainment of SEEDS Trained Early Childhood Educators in 

Licensed Programs (2007-2011) 

4.0% 4.3% 

7.3% 

8.8% 

10.1% 

No Formal Schooling 

Less Than High School Diploma/GED 

High School Diploma/GED 

12.2% 

Some College 

AA in non‐ECE/CD 

6.1% 

22.0% 

AA in ECE/CD 

BA in non‐ECE/CD 

BA in ECE/CD 

25.3% 

Some Graduate School or Postgraduate Degree 

Source: Early Literacy Foundations Initiative, Client and Assessment Data Entry Template, 2007‐2011. 

Note: Early childhood educators and coaches may have participated in more than one SEEDS class, but are only counted once in these analyses. For these 

clients, their language and education data are as of their earliest class, in order to assess the status of these educators at the beginning of their 

participation in the SEEDS program. Family, Friend or Neighbor (FFN) informal child care providers are not included in these analyses. 

Language N=356; Education N=328. 

Other 

Unduplicated total, 

Spring 2007 – June 2011 

201 155 356 

59



Indicator: Number of children participating in Raising A Reader 

SEEDS classrooms also implemented Raising A Reader, a weekly rotating book bag program for 

families, which means there were mutually complimentary interventions on site to boost shared 

reading practices and impact children’s early literacy skills. Over 5,000 children participated in the 

program during 2010‐2011. 

Figure 48: Number of Children Participating in Raising A Reader 

New Existing 2010‐11 Total 

Children 2,564 2,830 5,394 


Indicator: Percentage of early education settings that provide high quality support for 

language and literacy 

Preschool Classrooms 

Research on teacher effectiveness shows that by focusing professional development on language 

and literacy and social‐emotional development, children are shown to be much better prepared for 

school and have higher academic achievement. The first indicators of change are the language 

environment, teacher‐child interactions, and language opportunities that teachers provide to 

children. 

First 5 SEEDS Quality coaches are trained to independently assess SEEDS classrooms teaching 

children ages 3‐5 using the Early Language and Literacy Classroom Observation Pre‐K Tool (ELLCO 

Pre‐K). The ELLCO Pre‐K is used to assess the following five classroom components: classroom 

structure, curriculum, the language environment, books and book reading, and print and early 

writing (in 2010‐11, the classroom structure component was not measured by most coaches and is 

therefore not analyzed in this report). Items are scored along a 5 point scale, where 1 is deficient 

and 5 is exemplary. From this scale, early childhood educators’ classroom scores can be categorized 

into three levels, indicating their classroom environment provides low‐quality support, basic 

support, or high‐quality support for language and literacy. In every Pre‐K SEEDS course since 2007, 

coaches used the ELLCO to assess the classrooms of their mentees (early childhood educators 

receiving SEEDS training) at the beginning and end of the semester. 





Across all components, classrooms showed substantial improvements from the beginning of the 

semester to the end. Overall, the percentage of classrooms that were rated as having High‐Quality 

Support increased from 16% to 92%. Among the individual classroom components, by the end of the 

semester the majority of classrooms were rated as having High‐Quality Support in “Curriculum” 

(81%), “Language Environment” (76%), “Books and Book Reading” (87%), “Print and Early Writing” 

(89%). 

Figure 49: Classroom Support for Language and Literacy (2010-2011) 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

16.2% 

54.1% 

91.9% 

Low‐Quality Support Basic Support High‐Quality Support 

18.9% 

51.4% 

81.1% 

Source: Early Literacy Foundations Initiative, Early Language and Literacy Classroom Observation (ELLCO) Pre‐K, 2010 – 2011. 

Note: Low‐quality support = means less than or equal to 2.5; Basic support = means between 2.51 and 3.5; High‐quality support = means between 

3.51 and 5. Percentages less than 3% are not labeled. 

N=37. 

Four specific ELLCO items were chosen for individual study, using the same type of analysis: 

Opportunities for Child Choice and Initiative, Approaches to Book Reading, Support for Children's 

Writing, and Approaches to Curriculum. For these four items, several years of data have been 

aggregated in order to present a more robust portrait of the extent to which SEEDS‐trained early 

childhood educators were providing high quality support for language and literacy in their preschool 

classrooms. 

As reflected in this figure, SEEDS‐coached teachers have consistently improved the quality of 

support they provide in their classrooms for children’s development of early literacy. For each of the 

four ELLCO items, the majority of classrooms were rated as providing high quality support at post 

assessment: Opportunities for Child Choice and Initiative (93%), Approaches to Book Reading (88%), 

Support for Children's Writing (90%), and Approaches to Curriculum (87%). 

16.2% 

51.4% 

75.7% 

13.5% 

56.8% 

86.5% 

29.7% 29.7% 32.4% 29.7% 

24.3% 

18.9% 

13.5% 

8.1% 

21.6% 

35.1% 

43.2% 

89.2% 

Pre Post Pre Post Pre Post Pre Post Pre Post 

Overall Section 2: 

Curriculum 

Section 3: 

The Language 

Environment 

Section 4: 

Books & Book 

Reading 

61 

8.1% 

Section 5: 

Print & Early 

Writing



Figure 50: Key Language and Literacy Questions (2007-2011) 

100% 

80% 

60% 

40% 

20% 

0% 

53.7% 

35.8% 

93.3% 

10.4% 15.3% 19.5% 22.4% 

6.7% 

10.7% 

10.0% 

Source: Early Literacy Foundations Initiative, Early Language and Literacy Classroom Observation (ELLCO) & ELLCO Pre‐K, 2007 – 2011. 

Note: Clients may be included more than once if they participated in multiple SEEDS classes between 2007 and 2011. Low‐quality support = means 

less than or equal to 2.5; Basic support = means between 2.51 and 3.5; High‐quality support = means between 3.51 and 5. Percentages less than 3% 

are not labeled. 

* The analysis of this question began in 2007‐08, so results reflect the combined data for 2008‐2011. 

Child Choice and Initiative N=134, Book Reading N=215, Children's Writing N=221, Approaches to Curriculum N=134. 

Family Child Care Settings 

35.3% 

49.3% 

88.4% 

The data above described the ways that SEEDS‐trained teachers made changes to their preschool 

classroom environments and their practices in order to better support children’s development of 

pre‐literacy skills. However, SEEDS training was not just limited to preschool center teachers — early 

childhood educators from family child care settings as well as infant/toddler centers also 

participated in SEEDS training and received SEEDS coaching. Their sites were observed at the 

beginning of their SEEDS training and again at the end. 

31.2% 

49.3% 

89.6% 

40.3% 

37.3% 

The figure below presents the PRE and POST scores gathered from Family Child Care providers on 

four literacy‐related indicators, for several years combined. The measurement instrument was the 

Family Child Care Environment Rating Scale, Revised Edition (FCCERS‐R). Items were scored using a 

7‐point scale ranging from inadequate to excellent. Results show that providers made pre to post 

gains in their abilities related to literacy promotion. 

86.6% 

12.7% 

Pre Post Pre Post Pre Post Pre Post 

Opportunities for 

Child Choice and 

Initiative* 


Approaches to 

Book Reading 

Support for 

Children's Writing 

Approaches to 

Curriculum* 



Excellent 

7 

6 

5 

4 

3 

2 

1 

0 

Inadequate 



Figure 51: Average FCCERS Scores at Pre and Post Assessment on Literacy-Related 

Items (2009-2011) 

5.46 5.44 

3.83 3.93 3.94 

Source: Early Literacy Foundations (ELF) Initiative, Family Child Care Environment Rating Scale, Revised Edition, 2009‐2011. 

N=54. 

Infant/Toddler Care Classrooms 

The figure below presents the PRE and POST scores gathered from center‐based early childhood 

educators of Infant/Toddler care, for several years combined. The measurement instrument was the 

Infant/Toddler Environment Rating Scale, Revised Edition (ITERS‐R), and items were scored using a 7‐ 

point scale ranging from inadequate to excellent. Results show that Infant/ Toddler teachers 

enhanced their classroom environments and practices to promote children’s early literacy 

development. 

Figure 52: Average ITERS Scores at Pre and Post Assessment on Literacy-Related 


Excellent 

7 

6 

5 

4 

3 

2 

1 

0 

Inadequate 

Helping children 

understand language 

4.39 

6.02 



Helping children use 

language 

4.82 

6.14 


language 

Pre Post 

Pre Post 

Source: Early Literacy Foundations (ELF) Initiative, Infant/Toddler Environment Rating Scale, Revised Edition (ITERS‐R), 2009‐2011. 

N: Understand language=49, Use language=49, Using books=49, Interactions=48. 

5.65 

4.24 

5.80 

Using books Provider‐child 

interactions 

3.78 

5.76 

4.60 

5.92 

Using books Provider‐child interactions 

63



Increase Early Literacy Skills of Children 

Indicator: Percentage of children who demonstrate research‐based predictors for reading 

success 

The SEEDS of Early Literacy has shown us that teachers of diverse educational backgrounds can be 

trained to implement strategies to help children build a strong language and literacy foundation. 

First 5 partnered with SEEDS state subsidized classrooms and found that, indeed, teachers have had 

a positive effect on children’s language and literacy development. Participating classrooms assessed 

children throughout the year to measure changes in three key areas of reading predictors: picture‐ 

naming, rhyming, and alliteration. As the majority of students are dual language learners, most 

children were assessed in both English and Spanish, unless English was their primary language. 

Children showed large improvements in all three pre‐literacy skills areas between their first and last 

assessments. The percentage of all children scoring “At” or “Above” the target level for each of the 

pre‐literacy skills areas increased dramatically, with the greatest improvement occurring in rhyming 

and alliteration skills. 

Because of the number of English‐language learners in these classrooms (who comprised 

approximately 73% of children in this assessment), there was interest in focusing on the 

performance of children when assessed in their primary language. When looking at the percentage 

of children scoring “At” or “Above” target level, results show that when assessed in their primary 

language, Spanish‐speaking children started with a lower skill level than English‐speaking children, 

but by their last assessment they had made a greater amount of improvement (net change in 

percentage) in rhyming (39% increase vs. 30% increase), and in alliteration (53% increase vs. 46% 

increase). Primarily Spanish‐speaking children showed similar or even greater amounts of 

improvement when assessed in English, with the greatest increases occurring in rhyming (44% 

increase) and alliteration (54% increase). 

Figure 53: Percentage of Children Scoring “At” or “Above” the Target Level in Three 

Pre-Literacy Skill Areas, by Primary Language, 2010-2011 

100% 

90% 

80% 

70% 

60% 

50% 

40% 32.3% 

30% 

20% 

10% 

0% 

Primarily English‐Speaking 

Children 

English Assessment 

62.1% 

57.1% 

Picture 

Naming 

31.0% 

18.5% 

56.9% 

48.9% 

21.7% 

68.1% 

29.3% 

26.0% 

13.6% 

6.3% 

7.7% 

Rhyming Alliteration Picture 

Naming 

56.0% 

46.5% 


18.9% 

72.3% 


Naming 

Oct Jan May 

Primarily Spanish‐Speaking Children 

Spanish Assessment English Assessment 

50.0% 

25.6% 30.6% 

18.0% 

4.9% 5.8% 7.2% 

49.8% 

61.1% 

Rhyming Alliteration




Figure 54: Percentage of Children Meeting Targets for Later Reading Success, 

by Primary Language 

LANGUAGE OF 

ASSESSMENT 

PRIMARILY ENGLISH‐SPEAKING CHILDREN NET CHANGE 

TOPIC AREA OCT JAN MAY 

English Picture Naming 32.3% 62.1% 57.1% 24.8% 

LANGUAGE OF 

ASSESSMENT 

Rhyming 18.5% 31.0% 48.9% 30.4% 

Alliteration 21.7% 56.9% 68.1% 46.4% 

PRIMARILY SPANISH‐SPEAKING CHILDREN NET CHANGE 

OCT JAN MAY 

Spanish Picture Naming 6.3% 13.6% 29.3% 23.0% 

Rhyming 7.7% 26.0% 46.5% 38.8% 

Alliteration 18.9% 56.0% 72.3% 53.4% 


Rhyming 5.8% 30.6% 50.0% 44.2% 

Alliteration 7.2% 49.8% 61.1% 53.9% 

Source: Early Literacy Foundations Initiative, Individual Growth and Development Indicators (IGDI’s) Assessment Tool, 2010‐2011. 

English Speakers: English N= Oct: Picture Naming (93); Rhyming (92); Alliteration (92). N= Jan: Picture Naming (58); Rhyming (58); Alliteration (51). N= 

May: Picture Naming (91); Rhyming (90); Alliteration (91). Spanish Speakers: Spanish N= Oct: Picture Naming (222); Rhyming (222); Alliteration (222). 

N= Jan: Picture Naming (206); Rhyming (204); Alliteration (209). N= May: Picture Naming (229); Rhyming (228); Alliteration (224). Spanish Speakers: 

English N= Oct: Picture Naming (247); Rhyming (240); Alliteration (236). N= Jan: Picture Naming (217); Rhyming (206); Alliteration (211). N= May: 

Picture Naming (246); Rhyming (242); Alliteration (234). 

Note: Table displays the percentage of children scoring “at” or “above” the target level in these three pre‐literacy skill areas. Children who completed 

any two assessments within a pre‐literacy skill area were included in the analysis of that skill. Children were determined to be primarily English 

speakers if they were marked as being “English‐only” speakers on the scoring template, or if they did not take any assessments in Spanish. Children 

were determined to be primarily Spanish speakers if they were not marked as being “English‐only” speakers on the scoring template, and if they took 

at least one assessment in Spanish. The number of children marked as being “English‐only” speakers who also completed an additional assessment in 

Spanish was too low to analyze. 

Indicator: Percentage of children who recognize letter sounds (pre/post) 

Pre‐school children who participated in two educational programs provided by Migrant Education 

were assessed in their ability to recognize letter sounds in their primary language. Over 90% of all 

students who participated in these programs increased their letter sound recognition by at least five 

letter sounds, and on average, students learned to recognize 17 new letter sounds by the time they 

left the program. 

65



Figure 55: Changes in Students’ Letter Sound Recognition Skills After Participation in 

Migrant Education Pre-School Programs 

Percentage of Students Who Increased Their Letter 

Sound Recognition By At Least 5 Letter Sounds 

100% 

80% 

60% 

40% 

20% 

0% 

90.3% 

Average Number of Letter Sounds Recognized 

at Pre and Post Assessment 

Source: Migrant Education Summer Pre‐K and School Readiness Programs: Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 

2011. 

N=124. 

Increase Use of Kindergarten Transition Practices 

The Child Snapshot form was developed in partnership between kindergarten teachers and early 

childhood educators as an easy and effective way to support children’s transition to kindergarten. 

The Snapshot is a three‐page form completed by both the parent and the preschool teacher in the 

spring prior to kindergarten, and it includes brief information about the child’s interests and 

abilities, language or developmental concerns, preschool experience, and developmental 

information. As such, the form provides kindergarten teachers with family and preschool 

information about their students, and helps them become more familiar with the preschool and 

child care programs which feed into their elementary schools. 

The number of children with Child Snapshots completed on their behalf continues to grow, and 

illustrates increased communication between early childhood and elementary school settings, and 

the achievements being made to bridge children’s transition to kindergarten. 

� In Spring 2011, a total of 976 preschool children were assessed—509 boys (52%) and 467 

girls (48%). These children were drawn from 42 preschool programs throughout Santa Cruz 

County and their child snapshot forms were shared with kindergarten teachers at 42 

elementary schools in Santa Cruz County and surrounding areas. 


20 

15 

10 

5 

0 

1.2 

17.9 

Pre Post 

Indicator: Number of children who have a Child Snapshot completed on their behalf




Figure 56: Number of Child Snapshot Forms Collected from Participating Preschool 

Programs 

Source: Applied Survey Research, Child Snapshot Log, 2006‐2010, and Portrait of School Readiness 2011: Transition to Kindergarten—Child Snapshot. 

Pre‐Kindergarten Observation Form and cross‐walked DRDP‐PS, Spring 2011. 

Additionally, a measurement of kindergarten readiness was included at the end of the Child 

Snapshot, using either the Desired Results Developmental Profile ‐ Revised, Preschool (DRDP‐PS) or 

the Pre‐Kindergarten Observation Form (PKOF). Children were assessed across 24 readiness skills, 

which can be sorted into four domains, or Basic Building Blocks of Readiness: 1) Self‐Care & Motor 

Skills, 2) Self‐Regulation Skills, 3) Social Expression Skills, 4) Kindergarten Academics. The figure 

below displays children’s overall mean readiness scores as well as their average scores on each of 

the four Basic Building Blocks. 

Proficient 

In Progress 

Beginning 

1,000 

800 

600 

400 

200 

0 

393 

889 

617 

2006‐07 2007‐08 2008‐09 2009‐2010 2010‐11 

� Average readiness scores for the Basic Building Blocks ranged from 3.44 to 3.75 (on a scale of 

1 to 4), with an overall readiness score of 3.54. These results indicate that children who 

attended these preschools will be entering kindergarten with high levels of proficiency across 

all domains of readiness. 

Figure 57: Students’ Average School Readiness Levels Across the Basic Building 

Blocks of Readiness 

4 

3 

2 

Not Yet 

1 

3.54 

3.75 

Overall Readiness Self‐Care & Motor 

Skills 

Source: Applied Survey Research, Portrait of School Readiness 2011: Transition to Kindergarten—Child Snapshot. Pre‐Kindergarten Observation Form 

and crosswalked DRDP‐PS, Spring 2011. 

N = 900‐904. 

832 

976 

3.50 3.59 3.44 

Self‐Regulation 

Skills 

Social Expression 

Skills 

Kindergarten 

Academics 

67



The next figure highlights the readiness skills for which students were rated as demonstrating the 

most proficiency and the greatest challenges. 

� Readiness skill strengths were identified within the Self Care & Motor Skills, Social 

Expression, and Kindergarten Academics Basic Building Blocks. 

� Students were still developing the Kindergarten Academic skills involved in recognizing all 

letters of the alphabet and recognizing rhyming words, as well as the Self Regulation Skills 

involved in navigating peer relationships. 

Figure 58: Students’ Top Five Readiness Strengths & Challenges 

TOP FIVE STRENGTHS BASIC BUILDING BLOCK 

1. General coordination on the playground Self‐Care & Motor Skills 

2. Uses small manipulatives Self‐Care & Motor Skills 

3. Recognizes basic colors Kindergarten Academics 

4. Relates appropriately to adults other than parent/primary caregiver Social Expression 

5. Appropriately expresses needs and wants verbally in primary language Social Expression 

TOP FIVE CHALLENGES BASIC BUILDING BLOCK 

1. Recognizes letters of the alphabet Kindergarten Academics 

2. Recognizes rhyming words Kindergarten Academics 

3. Handles frustration well Self‐Regulation 

4. Negotiates with peers to resolve social conflict Self‐Regulation 

5. Participates successfully in circle time Self‐Regulation 

Source: Applied Survey Research, Portrait of School Readiness 2011: Transition to Kindergarten—Child Snapshot. Pre‐Kindergarten. Pre‐Kindergarten 

Observation Form and cross‐walked DRDP‐PS, Spring 2011. 

Note: Means are based on 415‐899 students. Don’t know/ Not observed responses are not included. Scale points are as follows: 1=not yet, 2= 

beginning, 3=in progress, 4=proficient. 


SERVICE INTEGRATION & 


Service Integration & Community Strengthening 

COMMUNITY STRENGTHENING 

First 5 Service Integration 


SERVICE INTEGRATION AND COMMUNITY STRENGTHENING 

Indicator: Number of families who receive services from multiple First 5 grantees 

First 5 Santa Cruz County seeks to strengthen the system of care in the county. One measure of the 

degree of current integration across the system is the number of children who are served by 

multiple First 5 grantees. Sometimes this occurs because grantees cross‐refer families, or because 

other agencies refer families into a coordinated network of First 5 services. In 2010‐11, 18% of 

children received services from multiple First 5 partners. 

Figure 59: Number of Children Receiving Services from Multiple First 5 Partners 

2006‐2007 2007‐2008 2008‐2009 2009‐2010 2010‐2011 

TOTAL NUMBER OF CHILDREN 4,462 5,214 5,440 5,762 9,292 

PERCENT WITH MULTIPLE 

FIRST 5 SERVICES 

Source: SUN database/CCD data for July 1, 2006 ‐ June 30, 2011. 

12.8% 20.3% 13.0% 14.6% 17.8% 

Figure 60: Percentage of Children Receiving Services from Multiple First 5 Partners 

30% 

20% 

10% 

0% 

12.8% 

20.3% 

13.0% 

14.6% 

17.8% 


Source: SUN database/CCD data for July 1, 2006 ‐ June 30, 2011. 

Note: 2006‐2007 data: N = 4,462. 2007‐2008 data: N = 5,214. 2008‐2009 data: N = 5,440. 2009‐2010 data: N = 5,762. 2010‐11 data: N = 9,292. 

69



Indicator: Distribution of Information to Community Service Providers 

Many health, social services, and early education providers in the county participated in workshops 

on various social and community issues to better integrate services and improve customer service, 

including 213 who participated in brown bag lunches, and 31 who attended customer service 

trainings. 

Indicator: Network of agencies that participated in Triple P 

As the Triple P program has expanded its levels of service, the number of agencies providing these 

services has also grown. By the end of FY 2010‐11, 86 practitioners from 20 agencies and programs 

had been accredited to provide Triple P services. First 5 implemented the following steps to build 

and enhance the Triple P referral system, and to provide integration between these agencies. 

� Maintained and distributed a contact list indicating which organizations have practitioners 

accredited in each Level of Triple P. 

� Disseminated flyers and descriptions of Triple P Seminars, Workshops, and Groups to service 

providers as a means to encourage referrals. 

� Publicized Triple P services in print and online editions of newspapers and community 

calendars. 

� Established First 5’s main phone number as a “warmline.” This number was publicized in all 

flyers, emails and media announcements as a central place to receive assistance locating 

Triple P services. First 5 staff were trained to conduct a brief screening in order to assess 

callers’ needs and make appropriate referrals. 

� Developed Triple P business cards containing First 5’s warmline and website address, as well 

as space for practitioners to insert their own contact information. 

� Enhanced First 5’s website to include information about Triple P, accredited practitioners, 

referral processes, and a master calendar of Triple P Groups, Workshops, and Seminars. 



First 5 Fiscal Status and Sustainability 

Indicator: Average Cost per Client 



The following figure presents data for the number of clients served by each First 5 partner, and the 

average cost per client. 

PARTNER 

Figure 61: Average Cost per Client, by Goal Area and Partner (2010-2011) 


JULY 2010 – 

JUNE 2011 

COSTS 

PARENTS 

CHILDREN 

(AGES 0‐5) 

NUMBERS SERVED 

EARLY 

CHILDHOOD 

EDUCATORS 

TRIPLE P 

CHILDREN 

(AGES 6+) 

TRIPLE P 

PRACTI‐ 

TIONERS 

AVERAGE COST PER INDIVIDUAL 

TOTAL 

PARTICIPANTS 

71 

COST PER 

PARTICIPANT 

Healthy Kids Initiative $865,315 2,704 2,704 $320 


Families Together $585,197 137 187 324 $1,806 

Triple P Services 1 $363,479 437 324 278 1,039 $350 

Training & 

Accreditation 

$88,275 94 94 $939 

Side‐By‐Side $95,000 41 41 $2,317 


La Manzana Community 

Resources 

Early Literacy 

Foundations Initiative 

$98,000 981 1,332 2,313 $42 

$320,069 104 104 $3,078 

Raising A Reader $231,556 5,394 5,394 $43 

Starlight Infant / Toddler 

Program 

Literacy Continuing 

Education Workshops 

Migrant Education ‐ 

Summer Pre‐K Academy 

Migrant Education School 

Readiness Program 

$515,000 104 54 158 $3,259 

$4,936 35 35 $141 

$39,622 156 156 $254 

$13,821 36 36 $384 

Source: First 5 Santa Cruz County and SUN database/CCD data for July 1, 2010 – June 30, 2011. 

1 Triple P provides services via several local practitioners and agencies, including three agencies that are already First 5 partners (Families Together, La 

Manzana Community Resources, and Mountain Community Resources). For these partners, clients who received Triple P services are reported as 

Triple P clients. If these clients also received other services from that partner, they are reported again as clients for that First 5 partner. Since 

Mountain Community Resources received First 5 funding to provide Triple P services, all of their clients are reported as Triple P clients in this table.



Indicator: First 5 Santa Cruz County’s Annual Balance Sheet 

The balances on this statement were as of June 30, 2011. The Statement of Net Assets indicates that 

net assets decreased by $3,864,306 from June 30, 2010 to June 30, 2011. This decrease in net assets 

is part of the Commission’s planned use of its sustainability fund for providing programmatic 

investments as set forth in the Strategic Plan and unforeseen liability of $3,390,246 incurred due to 

the passage of AB99 by the California Legislature. For the year ended June 30, 2011, the ending fund 

balance was $2,912,395, a decrease of $3,868,097 from the prior year. The Commission’s fund 

balance is allocated for the following categories: 

� $200,000 is restricted for private grants. 

� $2,712,395 is committed for program contracts. 

Figure 62: Balance Sheet, Fiscal Year 2010-2011 

Revenue Prop 10 Allocation $ 2,400,827 

Expenses Program 

Interest on Prop 10 Allocation $ 37,044 

School Readiness State Program Match $ 616,623 

David and Lucille Packard Foundation Grant $ 200,000 

Mental Health Services Act Contract $ 290,100 

HSD Title IV‐E Training Funds $ 82,226 

Other $ 20,298 

Total Revenue $ 3,647,118 

Children Learning & Ready for School $ 1,366,259 

Healthy Children $ 870,015 

Strong Families $ 1,131,951 

Family Friendly Services $ 59,162 

Transfer to State per AB99 $ 3,390,246 

Program Support $ 235,436 

Evaluation $ 202,380 

Administration $ 259,766 

Total Expenditures $ 7,515,215 

Excess of expenditures over revenues $ (3,868,097) 

Fund balance ‐ beginning of year $ 6,780,492 

Fund balance ‐ end of year $ 2,912,395 

Source: First 5 Santa Cruz County audited financial statements (2010‐2011). 





Indicator: Amount of matched or leveraged investments reported by First 5 partners 

Many partners maximize First 5 funding by using their funds as match money. In 2010‐2011, First 5 

funding was leveraged by these partners to bring in the following additional revenue. 

Figure 63: Amount of Leveraged Investments By Type 

SOURCE OF LEVERAGED FUNDING LEVERAGED FUNDING AMOUNT 

Medi‐Cal Administrative Activities (MAA) $282,604 

Early Periodic Screening Detection and Treatment (EPSDT) $80,215 

Public agency ‐ Federal $103,370 

Public agency ‐ State $1,321,022 

Public agency ‐ Local $771,000 

Educational Institution $131,131 

Private Foundation $688,660 

Business or Individual $384,962 

Total $3,762,964 

Source: First 5 Santa Cruz County and First 5 partner Annual Progress Reports, 2010‐2011. 

Figure 64: Total Amount of First 5 and Leveraged Investments, 2010-11 

$7,500,000 

$5,000,000 

$2,500,000 

$0 

$3,662,823 

$3,762,954 

Source: First 5 Santa Cruz County and First 5 partner Annual Progress Reports, 2010‐2011. 

$7,425,777 

$3,762,954 

$3,662,823 

Total First 5 Investment Total Leveraged Investments First 5 and Leveraged 

Investments Combined 

73



Community Strengthening 

Indicator: Access and utilization of the 2‐1‐1 program 

2‐1‐1 is a centralized point of contact for Santa Cruz County residents to get information on local 

services, and is accessible by phone or an online website. Trained specialists refer callers to local 

agencies and services that match their needs, and also help relieve the burden on 9‐1‐1 during 

disasters by providing non‐emergency information and referrals. This new county program, 

operated by the United Way of the Bay Area and funded by several local agencies including First 5 

Santa Cruz County, just completed its first year of service in July, 2011. 

Results show how effective this program was in helping residents with their everyday needs and 

concerns, and during emergency situations. In its first year, a total of 5,157 people called 2‐1‐1, with 

a total of 5,797 needs. Common types of needs included housing issues (24%), disaster services 

(12%), income support/assistance (11%), and food/meals (9%). A total of 7,347 referrals to agencies 

were made, including referrals to human services (30%), disaster assistance (10%), and health 

agencies (9%). 

7% 

Figure 65: Number of 2-1-1 Callers and Needs, 2010-11 

TOTAL NUMBER OF 2‐1‐1 CALLERS TOTAL NUMBER OF NEEDS TOTAL NUMBER OF REFERRALS 

5,157 5,797 7,347 

Source: United Way of Santa Cruz County, 2‐1‐1 Santa Cruz County Year One, Report to the Community, July 21, 2011, 2011. 

Figure 66: Types of 2-1-1 Callers’ Needs 

6% 

8% 

6% 

8% 

9% 

9% 

11% 

24% 

12% 

Housing 

Disaster Services 

Income Support/Assistance 

Food/Meals 

Legal, Consumer, & Public Safety 

Health Care 

Information Services 

Individual, Family, & Community Support 

Mental Health/Addictions 

Other Needs 

Source: United Way of Santa Cruz County, 2‐1‐1 Santa Cruz County Year One, Report to the Community, July 21, 2011. 

N=5,797. 



Figure 67: Types of 2-1-1 Referrals to Agencies 

5% 

6% 

7% 

4% 

4% 

8% 

4% 

Source: United Way of Santa Cruz County, 2‐1‐1 Santa Cruz County Year One, Report to the Community, July 21, 2011. 

N=7,347. 


5% 

8% 

9% 

30% 

10% 

Human Services 


Disaster Assistance 

Health Agencies 

Volunteer Income Tax Assistance 

Housing Services 

The Salvation Army Corps Community Center 

Catholic Charities 

Community Action Board 

St. Vincent De Paul Society of Santa Cruz 

Children's Services 

County of Santa Cruz Benefit Services 

Other Services 

75




FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT PARTNER PROFILES 

PART 2: 

PARTNER PROFILES 


77

PARTNER PROFILES FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT 



PARTNER PROFILES 

This section of the report provides a snapshot of each First 5 partner’s work between July 1, 2010 

and June 30, 2011. 

At the beginning of the 2010‐11 contract period, scopes of work were developed with each partner 

which detailed each program’s target population, the number of people to be served, primary 

programmatic activities, outcome objectives, methods of measurement, and the timing of data 

collection activities. Partners reported their outcome data quarterly or biannually, using the SUN 

database, customized Excel forms, or partner‐specific reports. In addition, a narrative template was 

provided to partners to submit qualitative information on the progress of their services. When 

collecting data for their outcome objective, some programs did not administer their assessment 

tools to every participant. For this reason the number of participants reported in their outcome 

measurement may differ from the total number of participants who were served. 

The purpose of the Partner Profiles is to highlight the work that each partner conducted in Fiscal 

Year 2010‐11. Organized by goal area (Healthy Children, Strong Families, and Children Learning and 

Ready for School), each profile briefly lists: 

� Description of the program 

� Population served 

� Client outcome objectives achieved (and in a few cases, program objectives achieved) 

Readers will note that in many cases, data that were presented in the Strategic Framework section 

are presented here again with the intent of summarizing the meaningful work that each of the 

partners carried out in the 2010‐11 year. 

Finally, it should be noted that these profiles only provide an overview of the innovative work that 

each partner or initiative carries out, and that more comprehensive detail about each partner’s 

progress is provided in their annual report to First 5. 


79


HEALTHY CHILDREN ‐ HEALTH CARE OUTREACH COALITION 

Healthy Kids Initiative 

Health Care Outreach Coalition 

Program Description 

The Health Care Outreach Coalition (HCOC) provides assistance with application and enrollment in 

public health insurance to income‐eligible families. Through community outreach workers called 

Certified Application Assistors (CAAs), children from families earning up to 300% of the Federal 

Poverty Level receive assistance in applying for Medi‐Cal, Healthy Families, and the local Healthy 

Kids health insurance plan. 

Additionally, HCOC staff participate in community events and respond to business and community 

agency requests for presentations and additional information regarding health insurance. HCOC 

assists in the management of the One‐e‐App online application system, providing training and 

technical assistance to all CAAs. 

Population Served 

2010‐2011 

Children 2,704 


“[We are] most proud of our CAAs’ commitment to helping 

parents navigate the often difficult and confusing processes 

of public health insurance programs. That CAAs request 

presentations and trainings on other community resources 

further exemplifies how seriously they take their roles 

as assistors.” 

- Health Care Outreach Coalition, Annual Progress Report 





Outcome Objective: Children will be assisted in applying for public health 

insurance 


Number of children assisted 2,846 

Source: Health Care Outreach Coalition, Annual Progress Report, 2011. 

Note: The number of children in this analysis may be slightly different than the total number of unduplicated children served, since families may come to 

HCOC for enrollment assistance more than once in the fiscal year. Enrollment and utilization results represent the status of children’s applications 2‐3 

months after the end of the fiscal year. 

Outcome Objective: Children will be enrolled in public health insurance 

By June 2011, 75% of the children ages 0‐5 who received assistance to 

apply will be enrolled in a public health insurance program 


89.0% 

N=1,944 





Outcome Objective: Children will be renewed in public health insurance 

By June 2011, 75% of the children ages 0‐5 who received assistance to 

apply will be renewed in a public health insurance program 


92.1% 





System Outcome: Children will utilize public health insurance 

85% of children renewing in public health insurance between July 1, 

2010 and June 30, 2011 will have utilized care prior to renewal 

N=902 


96.6% 




months after the end of the fiscal year, and utilization results exclude clients with missing data. 

N=829 

81



The following chart presents the percentage of applicants who were enrolled in health insurance, 

the percentage who re‐enrolled in insurance, and the percentage who utilized their benefits. 

Figure 68: HCOC Child Health Insurance Enrollment, Renewal, and Utilization 

Percentages 

100% 

95% 

90% 

85% 

80% 

75% 

70% 

99.6% 

93.8% 

85.7% 

Percent who utilized care prior to renewal in an insurance program 

Percent who were renewed in an insurance program 

Percent who were enrolled in an insurance program 

98.5% 

97.9% 

87.9% 

Source: Applied Survey Research, First 5 Santa Cruz County Final Reports, 2006 ‐ 2010. Health Care Outreach Coalition, Enrollment and Utilization 

Report, 2011. 

Note: The number of children in this analysis may be slightly different than the total number of unduplicated children served, since families may come 

to HCOC for enrollment assistance more than once in the fiscal year. Enrollment and utilization results represent the status of children’s applications 

2‐3 months after the end of the fiscal year. Utilization results exclude clients with missing data. 

Enrollment N: June 2007=678; June 2008=580. June 2009=730, June 2010=1,528, June 2011=1,944. Renewal N: June 2007=496; June 2008=530. June 

2009=592, June 2010=826, June 2011=902. Utilization N: June 2007=471, June 2008=514. June 2009=555, June 2010=789, June 2011=829. 

Health Care Outreach Coalition’s Newborn Enrollment Project: Baby Gateway 

99.6% 

98.0% 

Baby Gateway—the Newborn Enrollment Project—has now been launched in three local hospitals 

with funding and support provided by First 5 of Santa Cruz County: Watsonville Hospital (in August 

2009), Dominican Hospital (in January 2011), and Sutter Maternity & Surgery Center of Santa Cruz (in 

May 2011). 

The main goals of the project are to provide enrollment assistance to mothers and their newborns, as 

well as to establish a seamless Medi‐Cal coverage process for Medi‐Cal‐eligible newborns, and to link 

those newborns to a medical home, all before they leave the hospital. In addition, all new mothers 

receive the First 5 “Kit for New Parents” containing expert guidance for raising healthy infants and 

children. In particular, parents are oriented to the “What To Do If My Child Gets Sick” booklet, which 

provides information in utilizing primary care appropriately, and clarifies what issues should prompt a 

visit to the emergency room (and which should be handled in the medical home). 


99.4% 

93.7% 

85.6% 85.5% 

96.6% 

92.1% 

89.0% 

June 2007 June 2008 June 2009 June 2010 June 2011 

Utilization 

Outcome: 85% 

Enrollment & 

Renewal 

Outcomes: 

75%




Data from 2010‐11 show how successful this program has been in providing these services to Santa 

Cruz County’s mothers and newborns. 

� Of all 2,103 births that occurred in Santa Cruz County at these hospitals after the program 

had been implemented, 70% of mothers received a newborn visit while in the hospital, and 

65% received a “Kit for New Parents.” 

� Of all 1,499 mothers with Medi‐Cal births during 2010‐11, almost three‐fourths (74%) were 

assisted to complete a Medi‐Cal application for their new babies. 

� Of the 1,111 mothers who were assisted to complete a Medi‐Cal application for their 

newborns, nearly all applications (95%) were approved, and 97% were assigned a primary 

care provider for their child before discharge from the hospital. 

Figure 69: Newborn Enrollment Project Statistics, 2010-11 

PROGRAM COMPONENT WATSONVILLE 

Total Number of All Births in Santa Cruz 

County after program implementation 

COMMUNITY 

HOSPITAL 

DOMINICAN 

HOSPITAL 1 

SUTTER 

MATERNITY & 

SURGERY CENTER 

OF SANTA CRUZ 2 

1,487 437 179 2,103 

Total Number of Medi‐Cal Births 1,247 191 61 1,499 

Number of Completed Newborn 


Number of Approved Newborn 

Medi‐Cal Enrollments 

Number of Denied Newborn 


Number of Pending Newborn 


Number of Newborn Medi‐Cal 

Applicants with an Assigned 

Primary Care Provider 

Total Number of Newborn Visits 

(regardless of insurance status) 

Number of Kits for New Parents 

Distributed 

Source: Health Care Outreach Coalition, Newborn Enrollment Statistics, 2011. 



TOTAL 


MEDI‐CAL BIRTHS 

919 141 51 1,111 74.1% 


83 

MEDI‐CAL 

APPLICATIONS 

883 133 44 1,060 95.4% 

21 1 0 22 2.0% 

15 7 7 29 2.6% 

1,074 96.7% 


COUNTY BIRTHS 

1,040 289 136 1,465 69.7% 

1,040 184 136 1,360 64.7%



These Newborn Enrollment Project services may also have had an effect on the use of the 

Emergency Department (ED) for children less than one year old. As seen in the following figure, 

� ED visits at Watsonville Community Hospital were at a high of 632 in the 2 nd quarter of 2009. 

Baby Gateway was launched at that hospital in August 2009, and after that the number of ED 

visits dropped steadily to a low of 424 at the beginning of 2011. 

Figure 70: Number of Emergency Department Visits (Infants Less Than One Year Old) 

700 

600 

500 

400 

300 

200 

100 

0 

573 

218 

632 

Baby Gateway 


184 

552 558 

151 

171 

Source: Health Improvement Partnership of Santa Cruz County, Baby Gateway Program Report, August 16, 2011. 

506 

199 

528 

146 


471 


421 424 

Q1/2009 Q2/09 Q3/09 Q4/09 Q1/2010 Q2/10 Q3/10 Q4/10 Q1/2011 

168 

186 

Baby Gateway 

Launched 1/2011 

Watsonville Community Hospital 

Dominican Hospital





STRONG FAMILIES – FAMILIES TOGETHER 

Families Together provides an alternative, voluntary and prevention‐focused way for Santa Cruz 

County to respond to reports of abuse and neglect received by Family and Children’s Services (FCS). 

Of all the referrals to the child welfare screening unit, only about 8% meet the necessary criteria to 

receive services from FCS. By assisting these families, Santa Cruz County can intervene early, before 

family difficulties escalate to the point of maltreatment, in order to increase child safety, engage 

families in decision‐making, and to support healthy 

child development. 

Santa Cruz Community Counseling Center is the 

lead agency for Families Together. Other 

collaborative partners, such as Family and 

Children’s Services, a division of the Human 

Services Department (HSD), Health Services Agency, 

and Families in Transition also play critical roles in 

the program. 

Although families are referred through the Child 

Welfare System, they participate in Families 

Together voluntarily. This home visiting program 

includes comprehensive intake and risk assessment, 

development of a tailored case plan, parent 

support and education, child development 

activities, and periodic assessments. Using a 

strengths‐based approach, participating families 

are encouraged to identify goals and objectives that 

will support healthy family relationships, child health 

and safety, positive parenting, family literacy and 

school readiness. 

“Safety and basic needs have always been—and 

continue to be—crucial elements of the work we 

do with families. This year, we have really pushed 

the program forward in terms of parent education 

and mental health services for all families.” 

One family’s story: 

“[After receiving Triple P services,] Eduardo* was 

taking a more active role in the parenting, and 

seemed to respond to [the practitioner’s] assertion 

that his children admire him and need him to be 

an active parent. [He and his daughter] are better 

able to communicate, and [his wife] found that 

she was yelling less and the children were 

responding more. Though this family has many 

challenges ahead, they have learned imperative 

communication skills, appropriate limit-setting, 

and self-care skills. This foundation will surely 

benefit them as they continue to raise adolescents 

and young children.” 

-Families Together, Annual Progress Report 

(* Names have been changed) 

In Families Together, risk assessment serves a variety of purposes. First, the assessments help staff 

link parents with the appropriate service pathway, including brief services, intensive services, and 

referrals to Primeros Pasos, a program for parents struggling with alcohol and drug dependency. 

Follow up assessments help assess whether risk has been reduced. 

85




Families Together Pathway 

Brief Intensive Pending 

Subtotal 

All Pathways 

Participated in 

Triple P* 


Total 

All Pathways + Triple P 

(unduplicated) 

Parents/Guardians 57 77 3 137 25 146 

Children 80 104 3 187 (ages 0‐5) 27 

(ages 6‐16) 13 

(ages 0‐5) 191 

(ages 6‐16) 13 


Note: The risk assessment results guide the pathway assignment decision: families who score Low or Moderate work within the Brief Pathway with a 

Family Support Specialist for 3‐6 months. Those who score High or Very High work within the Intensive Pathway for up to 12 months, also with a Family 

Support Specialist. 

* These Triple P client numbers are estimates only, and are likely an undercount, as these data do not include clients from program levels that do not 

collect CCDs, and also exclude clients who did not consent to have their assessment data included in this evaluation. 

Outcome Objective: Families receive referrals, initial assessments, and assigned 

services 

Program Objectives 2010‐2011 

At least 280 new families will be referred from Family and Children’s Services to 

Families Together. 

75% of these new families referred to Families Together (who were successfully 

contacted) will agree to an initial meeting. 


188* 

88.6% 

N=123 

At least 150 primary caregivers will participate in Families Together. 137 primary caregivers 

95% of families participating in Families Together will receive an initial 

Structured Decision Making: Family Prevention Services Screening Tool 

(SDM:FPSST) risk assessment. 

99.2% 

Source: SUN database/CCD data for July 1, 2010 – June 30, 2011; Families Together Referral and Initial Engagement Form, 2011 and Annual Progress 

Report, 2011. 

* This number refers to participant referrals, not unique participants. If the same participant was referred more than once, each referral is tracked 

separately. Due to the complicated nature of tracking the ever‐changing status of each referral, this number represents the best estimate of the total 

number of referrals. 

N=132


Figure 71: Case Flow Diagram (2010-11) 

Contact 

and 

meeting 

plans still 

in progress 

29 


Contact ended: 

Unable to contact 

(68.7%), 

Declined to meet 

(26.4%), 

Case reopened in CWS 

(4.2%), or 

Ineligible for services 

(0.7%) 

Referral Closed 

69 

Cases Referred to Families Together (FT): 188* 

Contact ended: 

Did not show up to 

meeting 

(4.5%), or 

Met but declined to 

participate (95.5%) 

Referral Closed 



Contacted and initial meeting scheduled 

90 

Consented to participate in FT 

OR 

Referred to Primeros Pasos**: 

Source: Families Together Referral and Initial Engagement Form, 2011 and Annual Progress Report, 2011. 

* Numbers in this case flow diagram refer to participant referrals, not unique participants. If the same participant was referred more than once, each 

referral is tracked separately. Due to the complicated nature of tracking the ever‐changing status of each referral, these numbers represent the best 

estimate of the total number of referrals. 

** Primeros Pasos is a companion program to Families Together serving participants with intensive substance abuse issues. 

Outcome Objective: Families demonstrate decreased levels of risk 

Client Outcome Objective 2010‐ 2011 

75% of primary caregivers who received intensive services will demonstrate decreased risk 76.5% 

Source: SUN database, Structured Decision Making: Family Prevention Services Screening Tool (SDM:FPSST) data, 2010‐11. 

As seen in the following figure, the Structured Decision Making: Family Prevention Services Screening 

Tool used in the Families Together program is helping to show that families reduce their level of risk 

while in the Families Together program. In 2010‐11, over 76% of parents were found to have lower 

levels of risk at post assessment than at pre assessment. 

79 

N=81 

87



Figure 72: Percentage of Families Together Participants Who Showed Decreased Risk 

of Child Maltreatment 

100% 

80% 

60% 

40% 

20% 

0% 

81.0% 

71.1% 

Source: SUN database, Structured Decision Making: Family Prevention Services Screening Tool (SDM:FPSST) data, 2006‐11. 

Although very few families had a “low risk” score at baseline, these families were omitted from these analyses so that only those who could 


In 2008‐09, this risk assessment included both families receiving intensive services and those receiving brief intervention services. Long‐term clients 

were assessed at intake, 6 months, and 12 months, and clients receiving brief interventions were assessed at intake and the end of services. 

A second view of these risk assessment data involves a comparison of the percentage of families at 

each level of risk over four assessments (baseline, and first, second, and third reassessments). Each 

year’s analysis is constrained by fairly small sample sizes. Therefore, several years of data have been 

aggregated in order to present a more robust portrait of the extent to which Families Together 

participants are reducing their risk for future involvement with the child welfare system. 

60.6% 

63.0% 

As can be seen in the figure, 62% of families were assessed as being high risk or very high risk upon 

intake, and this dropped to 13% by the third reassessment, indicating that the program is helping 

families reduce their level of risk. 

Figure 73: Change in Families Together Participant’s Risk Levels Over Time, 

2007 - 2011 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

2006‐2007 

(N = 42) 

44.7% 

38.4% 

Baseline* 

(N = 237) 

16.9% 

2007‐2008 

(N = 45) 

28.1% 

49.7% 

20.0% 

1st Reassessment 

(N = 185) 

2.2% 

2008‐2009 

(N = 66) 

29.4% 

51.5% 

14.7% 

2009‐2010 

(N = 128) 

26.7% 

60.0% 

76.5% 


(N = 81) 

13.3% 

Source: SUN database, Structured Decision Making: Family Prevention Services Screening Tool (SDM:FPSST) data, 2007‐2011. 

* Although very few families had a “low risk” score at baseline, these families were omitted from these analyses so that only those who could 


Note: Due to inaccuracies in data entry in 2006‐07, clients with baseline assessments before 7/1/07 were omitted from this analysis. 


4.4% 

2nd Reassessment 

(N = 68) 

0.0% 

3rd Reassessment 

(N=15) 

Low Risk 

Moderate Risk 

High Risk 

Very High Risk




Outcome Objective: Families are less likely to experience recurrence of abuse 

Client Outcome Objective 2010 

Of families who participated in the Differential Response program, at least 95% 

of families will not have a substantiated allegation of child maltreatment within 

6 months of case closure. 

96.3% 

Source: Santa Cruz County Human Services Department, Planning and Evaluation Unit. Staff analysis of CWS/CMS data, September 2011. 

Note: Data are from the 2010 calendar year, in order to allow at least a 6 month period after case closure. 

Results show that families who participated in the Differential Response program are less likely to 

experience recurrence of abuse. 

� Of the 82 families who received services from Families Together and had their cases closed in 

the 2010 calendar year, 96% had no substantiated allegations of maltreatment within six 

months after case closure. This figure is comparable to what was observed in the previous 

two years. 

Figure 74: Percentage of Families Together Participants Who Do Not Have a 

Substantiated Allegation of Maltreatment Within 6 Months After Case 

Closure 

100% 

90% 

80% 

95.1% 

92.0% 

Source: County of Santa Cruz, Human Services Department, staff analysis of CWS/CMS data. 

Note: Data are from each respective calendar year, in order to allow at least a 6 month period after case closure. 

N: (2008‐09) N=61, (2009‐10) N=74, (2010‐11) N=82. 

Outcome Objective: Children have health insurance and a medical home 

Client Outcome Objective 2010‐ 2011 

98% of children ages 5 and under have health insurance by exit from the 

program. 

98% of children ages 5 and under will have a medical home by exit from the 

program. 

96.3% 

2008‐09 2009‐10 2010‐11 

N=82 

100% 

N=114 

99.1% 

N=113 

Source: SUN database, 2010‐2011. 

Note: A total of 116 children had closed cases, but children in families who left the program prematurely were not included in these analyses. 

89



Outcome Objective: Families will have access to parenting support services 

structured by the Triple P curriculum 

Client Participation in Triple P* 


Parents/Guardians 25 

Children (ages 0‐5) 27 

(ages 6‐16) 13 




Client Satisfaction with Triple P Services 

All Families Together parents receiving Triple P services were asked to complete a self‐administered 

satisfaction survey upon completing their services. Parents participating in Levels 3 (multi‐session), 

4, and 5 of the Triple P Program filled out a Parent Satisfaction Survey with 13 questions using a 7‐ 

point scale (with 7 indicating highest satisfaction), and 3 open‐ended questions. The average parent 

satisfaction ratings ranged from 5.33 to 6.83, on the 7‐point scale. Most parents felt that the 

program met their needs, met the needs of their children, offered the help that they needed, and if 

they needed help in the future, they would return to Triple P. 

Figure 75: Parents’ Satisfaction with Various Aspects of the Triple P Program 

1. How would you rate the quality of the service you and your child 

received? (N=12) 

2. Did you receive the type of help you wanted from the program? 

(N=12) 

3. To what extent has the program met your child's needs? (N=12) 

4. To what extent has the program met your needs? (N=12) 

5. How satisfied were you with the amount of help you and your child 


6. Has the program helped you to deal more effectively with your 

child's behavior? (N=12) 

7. Has the program helped you to deal more effectively with 

problems that arise in your family? (N=12) 

8. Do you think your relationship with your partner has been 

improved by the program? (N=9) 

9. In an overall sense, how satisfied are you with the program you 

and your child received? (N=10) 

10. If you were to seek help again, would you come back to this 

organization? (N=10) 

11. Has the program helped you to develop skills that can be applied 

to other family members? (N=10) 

12. In your opinion, how is your child's behavior at this point? (N=10) 

13. How would you describe your feelings at this point about your 

child's progress? (N=10) 

Source: Triple P data from the Parent Satisfaction Survey, collected and analyzed by Applied Survey Research, 2011. 

Note: All items were on a 7‐point scale. Higher scores indicate greater satisfaction. 


5.33 

6.08 

6.08 

6.00 

6.67 

6.58 

6.50 

6.50 

6.50 

6.50 

1 2 3 4 5 6 7 

6.83 

6.75 

6.80


STRONG FAMILIES – TRIPLE P 

Triple P – Positive Parenting Program 


Triple P (Positive Parenting Program) is a comprehensive, evidence‐based parenting and family 

support system designed to increase parents’ confidence and competence in raising children, improve 

the quality of parent‐child relationships, and make evidence‐based parenting information and 

interventions widely accessible to parents. It is based on a public health model in which an ecological 

approach is used. This approach initiates activities at individual, family, community and systemic levels 

to provide a comprehensive structure of support. 

There are five levels of intervention in Triple P. Level 

One practitioner’s story: 

1 is intended to reach a broad range of community 

members in the County, and as the levels increase, 

more intensive services are provided: 

� Level 1: Universal involves a media‐based 

parenting information campaign. 

� Level 2: Selected Individual & Seminar 

provides information or advice for a 

specific parenting concern. 

� Level 3: Primary Care offers narrow‐focus 

parenting skills training. 

� Level 4: Standard & Group includes broad‐ 

focus parenting skills and training. 


“The main areas that the family focused on came to 

the surface pretty quickly, and as we discussed 

assertive discipline, avoiding arguments in front of 

the children, planned ignoring, quiet time, and time 

out, the couple started to properly use the strategies 

they learned in the class. It seemed almost like a 

natural progression in which discussing the 

aforementioned topics led to the parents supporting 

each other as they tested them out with their family. 

It was amazing how they worked cooperatively to 

develop and implement their Planned Activities 

Routine. … [One parent] stated in the last session, 

‘This program gives you a positive way to 

discipline.’” 

-Triple P practitioner, Annual Progress Report 

� Level 5: Enhanced & Pathways offers 

additional interventions for families with risk factors for child abuse or neglect. 

Triple P focuses on 17 core parenting skills that are grouped into 4 areas: promoting positive 

relationships, encouraging desirable behavior, teaching new skills and behaviors, and managing 

misbehavior. It is based on a self‐regulatory framework in which the practitioner provides 

information, skills, training, and support based on the parents’ concerns. Parents use self‐evaluation 

to set goals and assess progress. While practitioners are helping parents to build confidence and 

competence, parents are helping children to build these skills in a parallel process. 

Beginning in early 2010, three local funders (First 5 Santa Cruz County, Health Services Agency, and 

Human Services Department) launched a pilot of the Triple P system in partnership with other 

agencies that serve children and families. The pilot phase is expected to last a minimum of two 

years. During the pilot phase, Triple P is being implemented incrementally, beginning with Levels 3, 

4, and 5 in the first year, and adding Levels 1 and 2 in this second year. The long‐term vision is to 

implement every level of Triple P broadly in Santa Cruz County to make parenting information and 

support available to all families. 

91



The following diagram illustrates the design of this program, and the results that have been 

achieved towards addressing the program’s incremental levels of parenting support and 

information. 

Level 5: Enhanced & Pathways 

Additional support for families where parenting issues are compounded by parental stress and/or relationship 

difficulties, or there is risk for child maltreatment. 


� Trained and accredited 18 practitioners to provide Level 5 Enhanced services, and 18 for Level 5 Pathways. 

� Parents are beginning to receive Level 5 services, and will complete assessments to measure improvement 

in their parenting skills and understanding of their children’s behavior. 


In-depth training in positive parenting skills. 


� Families showed significant improvements in: 

– style of discipline – confidence in their parenting – levels of conflict over parenting – level of satisfaction with 

their relationship – levels of parental depression – stress and anxiety – child behavior 

� Parents who had more serious parenting issues made the most meaningful changes in their family life. 

� Parents reported high levels of satisfaction with their services. 

� Approximately 282 parents/guardians have participated in Level 4 sessions. 

� Trained and accredited 38 practitioners to provide Level 4 Group services, and 37 for Level 4 Standard. 


Consultations about specific parenting concerns. 


� Families showed significant improvements in children’s behavior, confidence in parenting skills, and support from parenting 

partners. 

� Parents reported high levels of satisfaction with both Level 3 workshops and individual/group sessions. 

� Approximately 336 parents have participated in Level 3 workshops, and 35 in Level 3 Individual/Group sessions. 

� Trained and accredited 53 practitioners to provide Level 3 Primary Care services, and 5 with Special Accreditation in Level 3. 


General information and tips for specific parenting concerns. 


� Parents reported great satisfaction with Level 2 seminars, particularly noting that they would continue to use the strategies that they learned. 

� Approximately 96 parents have participated in Level 2 seminars, and 104 in Level 2 Individual sessions. 

� Trained and accredited 20 practitioners to provide Level 2 seminars, and 53 for Level 2 Individual sessions. 


Media-based parenting information campaign. 


� Enhanced First 5’s website to include information about Triple P, accredited practitioners, referral processes, and a master calendar of Triple P Groups, 

Workshops, and Seminars. 

� Disseminated flyers and descriptions of Triple P Seminars, Workshops, and Groups to service providers as a means to encourage referrals. 

� Publicized Triple P services in print and online editions of newspapers and community calendars. 

� Established First 5’s main phone number as a “warmline,” publicized in all flyers, emails and media announcements as a central place to locate services. 

� Delivered Triple P messages on TV and the radio. 




Triple P Highlights 

Triple P is a multi‐level system of parenting and family support interventions of varying intensities 

and formats. Its population‐based approach to parenting support provides the minimally sufficient 

level of care for parents to enable them to independently manage their family issues. This section 

provides an overview of how families in Santa Cruz County have been helped to receive the levels of 

support that they needed through their participation in Triple P, and highlights some of the key 

achievements in each of these levels. 


Activities and media strategies for Level 1 of Triple P are providing access to positive parenting 

information and destigmatizing the need to get help for parenting issues. 

� Accessibility of information. Families are responding to print and radio media, 

they are using the updated website to register for parenting classes, they are 

calling the “warmline,” and professionals county‐wide are referring families to 

the classes they need. 

� Encouragement to participate. During this 2010‐11 funding cycle, at least 893 

parents and 1,518 children have participated in Triple P services. 

Client Participation in Triple P 


2010‐11 


Children (all ages) 1,518 

For more information 

See “Building a Population‐ 

Based System of Parent 

Education” on page 125. 


See “Population Served” on 

page 99. 

Source: SUN database/CCD data for July 1, 2010 – June 30, 2011; Triple P program data analyzed by Applied Survey Research, 2011. 

Note: These Triple P client numbers are estimates, as they may include some duplicates, and also exclude clients who did not consent to have their 

assessment data included in this evaluation. 

� Satisfaction with services. On average, parents rated the quality of services very 

high, noting that they had received the help they wanted, were dealing more 

effectively with problems in their family, and would come back to the program if 

they needed to seek help again. 

Parents’ Satisfaction with Various Aspects of the Triple P Program 

How would you rate the quality of the service you and your 

child received? (N=198) 

Did you receive the type of help you wanted from the 

program? (N=196) 

Has the program helped you to deal more effectively with 


If you were to seek help again, would you come back to this 


Source: Triple P data from the Parent Satisfaction Survey, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 



See “Satisfaction with 

Services” on page 121. 

6.47 

6.34 

6.40 

6.43 

1 2 3 4 5 6 7 

93

Higher 

is 

“Better” 




Level 2 of Triple P is giving parents an opportunity to be introduced to Triple P and is providing easy 

access to general parenting support. 

� Gateway to more services. Of parents who participated in seminars and 

workshops, 21% requested follow‐up services, suggesting that these brief services 

may be an effective way of getting parents initially engaged in the program, and 

gives them an opportunity to participate in further services. 

� Continued use of the skills they learned. On average, parents felt that the 

seminars answered their questions, and that they would continue to use the 

strategies they learned. 

Seminar/Workshop Satisfaction Survey 

Source: Triple P data from the Seminar/Workshop Satisfaction Survey, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 



Brief consultations about specific parenting concerns are resulting in 

increased positive parenting experiences. 

� Support for specific parenting challenges. Parents are reporting 

increased confidence in parenting, more support from their partners, 

less difficulty with their children’s behavior, and increased enjoyment 

in their parent/child relationship. 

Extremely 

5 

4 

3 

2 

1 

0 

Not at all 

The seminar/workshop answered a question or concern I 

have had about parenting. (N=254) 

I am likely to use some of the parenting strategies in the 

tip sheet. (N=253) 

Increases in Positive Parenting 


See “Requests for Further 

Services” on page 123. 


See “Parents’Satisfaction with 

Seminars/Workshops” on 

page 122. 


See the improvements parents made in each of 

these Level 3 domains: 

� “Improved levels of confidence in parenting” 

on p. 105. 

� “Reduced levels of conflict over parenting” 

on p. 108. 

� “Increased support in their role as a parent” 

on p. 111. 

� “Increased levels of satisfaction with their 

relationship” on p. 112. 

� “Decreased levels of emotional difficulties” 

on p. 114. 

� “Improvements in child behavior” on p. 117. 

Source: Triple P data from the Parenting Experience Survey, Question 3, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 

Note: The Parenting Experience Survey measures issues related to being a parent. Each question is analyzed separately, under the corresponding 

domain in this analysis of the Triple P domains. For Q1‐6, scores range from 1 to 5. For Q7, scores range from 0 to 6. Higher scores indicate more 

positive parenting experiences. There are no clinical cut‐offs for this assessment. See page 102 for a description of the sub‐populations and 

analyses that were run. 

* Results marked with an asterisk had PRE/POST differences that were statistically significant at p

Lower 

is 

“Better” 




Through more intensive services, families are receiving in‐depth support for moderate to severe 

behavioral and emotional difficulties. 

� Increased use of positive discipline styles. There were significant improvements 

in parents’ style of discipline, indicating their parenting style became less lax, 

less over‐reactive, and less hostile though the course of the Triple P program. 

Dysfunctional 

Parenting 

Higher 

is 

“Better” 

7 

6 

5 

4 

3 

2 

1 

Functional 

Parenting 

Parents’ Discipline Styles 

3.3 

All Parents* 

(N=158) 


3.8 3.6 3.8 3.8 3.7 3.9 3.7 3.7 

2.7 2.9 3.0 2.9 3.0 2.9 3.0 2.9 3.0 

Clinical 

Range at 

PreTest* 

(N=86) 

Male* 

(N=20) 

Female* 

(N=66) 


See “Increased use of positive 

discipline styles” on page 103. 

Source: Triple P data from the Parenting Scale, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 







� Reduced levels of conflict over parenting. After completing the program, parents 

on average indicated that there were significantly fewer parenting and relationship 

issues that were problems. However, on average all parent sub‐populations were 

still in the clinical range by the post‐assessment. 

Number of Parenting Issues That Have Been a Source of Conflict Between Parents 

All issues were a 

problem 

16 

Pre Post 

Lower 

is 

“Better” 

12 

8 

4 

0 

No issues were a 

problem 

5.5 

3.5 

All Parents* 

(N=105) 

9.2 

Clinical 

Range at 

PreTest* 

(N=52) 

7.8 

5.7 5.2 

Male* 

(N=18) 

10.0 9.6 9.0 

Source: Triple P data from the Parent Problem Checklist, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 

Note: The Parent Problem Checklist measures the number of issues that have been a PROBLEM for parents, and the EXTENT of the problem for 

each issue. Scores for the PROBLEM subscale range from 0 (no issues were a problem) to 16 (all issues were a problem). Scores for the EXTENT 

subscale range from 16 (Not at all a problem) to 112 (Very much a problem). There is no clinical cut‐off for this subscale. See page 102 for a 

description of the sub‐populations and analyses that were run. 




� Decreased levels of emotional difficulties. The following figures indicate that on 

average, all sub‐populations (except Males) made significant improvement in 

lowering their level of depression, and all sub‐populations significantly improved 

their level of stress. On average they began the program within the Severe range, 

and ended out of a range of concern. 

Extremely severe 

distress 

42 

Lower 

is 

“Better” 

35 

28 

21 

14 

7 

0 

No distress 


distress 

42 

Lower 

is 

“Better” 

35 

28 

21 

14 

7 

0 

No distress 

Level of Parental Depression and Stress 

9.7 

5.8 

All Parents* 

(N=176) 

12.9 

7.8 

All Parents* 

(N=175) 


24.0 

10.8 

Clinical 

Range at 

PreTest* 

(N=48) 

21.3 

14.0 

Depression 

24.9 24.6 23.0 24.6 22.7 24.4 

9.8 

Male (N=12) Female* 

(N=36) 

Pre Post 

Stress 


See “Decreased levels of 

emotional difficulties” on 

page 114. 

Source: Triple P data from the Depression, Anxiety, and Stress Scale – Short Version (DASS‐21), collected and analyzed by Applied Survey Research, 

Jan. 2010 ‐ June 2011. 

Note: The Depression, Anxiety, and Stress Scale – Short Version (DASS‐21) measures distress along 3 scales: Depression, Anxiety, Stress. Scores for 

each scale are calculated by summing the participants’ responses for each of the 21 items. Higher scores on each of the scales indicate greater 

levels of depression, anxiety, and stress. Each scale has different clinical cut‐offs for the 5 severity levels: normal, mild, moderate, severe, and 

extremely severe. See page 102 for a description of the sub‐populations and analyses that were run. 

* Results marked with an asterisk had PRE/POST differences that were statistically significant at p=28 

Severe >= 21 

Moderate >=14 

Clinical Cut‐offs: 

Very Severe >=34 

Severe >=26 

Moderate >=19



� Improvements in child behavior. In Triple P, the parent is considered the agent of 

change to bring about improvements in the parent‐child relationship. Therefore, how 

parents view their children’s behavior is an important assessment of the relationship. 

For all sub‐populations, there was a significant reduction in the number of child 

behaviors that were perceived to be a problem. On average, most parents began with scores 

within the clinical range, and ended with scores that were out of the clinical range. 


a problem 

36 

Lower 

is 

“Better” 

30 

24 

18 

12 

6 

0 

No behaviors 



15.0 

8.2 

All Parents* 

(N=129) 

23.0 

Clinical 

Range at 

PreTest* 

(N=62) 

20.4 

Source: Triple P data from the Eyberg Child Behavior Inventory, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 


which parents view those behaviors to be a problem (Problem subscale). Intensity scores could range from 36 (Never occurs) to 252 (Always 

occurs), and Problem scores ranged from 0 (No) to 36 (Yes), with higher scores indicating greater frequencies of problem behaviors and greater 

likelihood that these behaviors were a problem to the parent. See page 102 for a description of the sub‐populations and analyses that were run. 



See “Child Welfare Study” on 

page 120.




The total number of clients who participated in Triple P is comprised of three groups: clients who 

participated in individual or group sessions AND who consented to have their assessment data 

anonymously included in this evaluation (who consequently provided enough information to create a 

Unique ID), those who participated in seminars or workshops where no names or personal information 

were collected, and those who did NOT consent to participate in the evaluation of Triple P. 

Source: (Consenting clients ) SUN database/CCD data for July 1, 2010 – June 30, 2011; (Seminar & Workshop clients & Non‐Consenting clients) Triple P 

program data analyzed by Applied Survey Research, 2011. 

* Includes parents and children for whom enough personal information was collected to be able to create a Unique ID. This includes parents participating 

in Levels 2 (Individual), and parents and children participating in Levels 3 (Primary Care), 4, and 5. 

**Includes parents and children in all Triple P program levels where no names or personal information were collected (such as seminars and workshops), 

and the children of parents who participated in Level 2 Individual sessions (where only parents had personal information collected). 

*** In addition to these totals, 5 parents/guardians and 11 children participated in individual or group sessions who did not have complete information, 

and therefore it is not known if they duplicate any of the clients recorded in the SUN database/CCD data. 



Clients Participating in Individual or Group Sessions – Unique IDs Created* 


AGES 

0 – 5 

AGES 

6 – 12 

AGES 

13 – 16 

AGES 

17+ 

Children 324 191 60 27 602 

Clients Participating in Seminars & Workshops – No IDs** 


Children (all ages) 864 

Clients Participating in Individual or Group Sessions – Did Not Consent to 

Participate in Evaluation 


Children (all ages) 52 

TOTAL*** 


Children (all ages) 1,518 

99



The following chart shows the approximate percentage of parents/guardians who participated in 

each level of Triple P. 

Figure 76: Estimated Percentage of Parents in Each Level of Triple P (2010-11) 

32.5% 

1.7% 


12.0% 

Multiple Levels* 

4.0% 

38.7% 

Source: Triple P participation data, collected and analyzed by Applied Survey Research, 2011. 

Notes: These are estimated percentages, as the data may include duplicated clients from program levels that do not collect CCDs, and also exclude 

clients who did not consent to have their assessment data included in this evaluation. 

* The number of parents participating in multiple levels of service is probably an undercount. Exact participation data are only available for levels of 

services where parents provided enough personal information to be able to create a Unique ID (Level 2 Individual, Level 3 Primary Care, and Level 4). 

Parents who participated in seminars and workshops did not provide enough personal information to be able to create a Unique ID, so it was not 

possible to track whether they also participated in additional levels of service. 

N=868 (see notes, above). 

Level 3 & 4 Participant Details 

In fiscal year 2010‐11, parents participating in Levels 3 or 4 were asked some basic information 

about their involvement in Triple P. 

� The top three ways that parents participating in Level 3 or 4 Triple P services had heard 

about the program were: Referred by another agency (28%), Flyer or brochure about Triple P 

services (11%), and Friend or relative (11%). 

� Approximately 42% were participating with another adult. 

� When parents filled out these assessments, they were asked to choose one child in their family 

(“Index Child”), and complete the assessments keeping just that one child in mind. Almost half 

(47%) of Index Children were between 0‐5 years of age, and 44% were between ages 6‐12. 

� Almost one quarter of parents participating in Level 3 and 4 services (24%) needed 

assistance filling out these assessments (e.g., having the questions read to them). 

Figure 77: How Participants First Heard about Triple P (2010-11) 

37.8% 

2.0% 

3.1% 

3.1% 

5.1% 

10.7% 

27.6% 

10.7% 


Note: Level 3 and Level 4 participants only. 

N=196. 

Level 2 Seminar 

Level 2 Individual 

Level 3 Workshop 

Level 3 Primary Care 

Level 4 

Referred by other agency 

Flyer or brochure about Triple P services 

Friend or relative 


School 

Child care or preschool provider 

Doctor's office 

Advertisement 

Other



Figure 78: Percentage of Parents Participating with Another Adult (2010-11) 



N=201. 

Figure 79: Ages of Children Chosen as the “Index” Child* (2010-11) 

43.8% 



* When parents filled out these assessments, they were asked to choose one child in their family (“Index Child”), and complete the assessments 

keeping just that one child in mind. 

N=379. 

Figure 80: Percentage of Parents Who Needed Assistance to Complete the 

Assessments (2010-11) 



N=132. 


No 

57.7% 

7.7% 1.3% 

No 

75.8% 

Yes 

42.3% 

Yes 

24.2% 

47.2% 

Ages 0‐5 

Ages 6‐12 

Ages 13‐16 

Ages 17+ 

101



Triple P Domains and the Collection of Assessment Data 

Parents who participated in levels 3 and 4 of the Triple P program completed assessments that 

measured their levels of parenting skills and knowledge along several domains. These domains 

identify key parenting issues, such that improvements in these areas generally result in 

improvements in overall family life. 

These domains include: 

� Increased use of positive discipline styles 

� Improved levels of confidence in parenting 

� Reduced levels of conflict over parenting 

� Increased support in their role as a parent 

� Increased levels of satisfaction with their relationship 

� Decreased levels of emotional difficulties 

� Improvements in child behavior 

Parents participating in Triple P services began to complete their first assessments in January 2010, 

so by the time of the 2009‐10 fiscal year evaluation, the amount of assessment data was still rather 

small. Therefore, in this evaluation, the assessment data from both the previous and current fiscal 

years (January 2010 – June 2011) have been aggregated in order to present a more robust portrait 

of the extent to which Triple P participants are developing their parenting skills and knowledge. 

Level 3 & 4 Assessments (Jan. 2010 ‐ June 2011) 

� Parents who participated in Level 4 of the Triple P program were asked to complete the 

following assessments (as appropriate to their relationship status and age of the child they 

were thinking of while completing the assessments): Eyberg Child Behavior Inventory, Child 

Behavior Checklist (Children’s Mental Health clients only), Parenting Scale, Parenting Tasks 

Checklist, DASS 21, Relationship Quality Index, and the Parent Problem Checklist. Analyses 

were run to see if there was any improvement between pre and post assessments, and if the 

amount of improvement was statistically significant. 

A first analysis was initially run on all parents combined, but additional analyses were run 

only on parents who scored in the clinical range on their pre‐assessments. Of these parents 

who began in the clinical range, specific “sub‐populations” were also examined to study the 

possible effects of certain circumstances and key demographics. These additional analyses 

studied the impact of gender, ethnicity, and language, and looked at parents who were 

currently involved in the child welfare system (identified by those receiving services at the 

Parents Center). Again, all of these sub‐populations only included parents who scored in the 

clinical range at pre‐assessment. Results were not shown for certain sub‐populations if there 

were not enough cases in that analysis. 





Parenting Experience Survey as a measure of issues related to being a parent. Each question 

in the Survey corresponds to one of the Triple P domains discussed in this profile of Triple P, 

and is evaluated individually under that domain. 

For each question in this assessment, a first analysis was initially run on all parents combined, 

and additional analyses were run on specific “sub‐populations” that contained enough clients 

to analyze separately, which included females, Latinos, and Spanish‐speaking parents. 

� “Effect Sizes” were also calculated on many of these analyses. When a result is statistically 

significant, it does not necessarily mean that the amount of change was very big. It simply 

means that we can be confident that there was a difference. To know if an observed 

difference is not only statistically significant but also important or meaningful, an “Effect 

Size” is calculated. 

Results for these assessments completed by Triple P clients are described under each of the 

following domains. 

Triple P Domain: Increased use of positive discipline styles 

Parents who participated in Level 4 of the Triple P program were asked to complete the Parenting 

Scale as a pre and post assessment of their style of discipline, such as being lax, over‐reactive, or 

hostile. Scores could range from 1 (positive parenting) to 7 (ineffective parenting), with lower scores 

indicating more positive styles of discipline. Analyses were run to see if there was any improvement 

between pre and post assessments, and if the amount of improvement was statistically significant. 16 

As seen in the figures below, there were significant improvements from pre to post assessment 

regarding parents’ style of discipline, indicating their parenting style became less lax, less over‐ 

reactive, and less hostile though the course of the Triple P program. Key results include: 

� When looking at Overall scores on the Parenting Scale, 

o On average, all parents combined and all parent sub‐populations that were assessed 

began in the clinical range, but by post‐assessment there had been significant 

improvement, and on average all parents had achieved positive styles of discipline. 

� For the Laxness, Overreactivity, and Hostility subscales, 

o All of the parent sub‐populations that were analyzed showed pre‐assessment results in 

the clinical range, and all of these sub‐populations had improved significantly out of this 

range by the end of the program. 

16 

For an explanation of the analyses that were run and the sub‐populations that were developed, see “Triple P Domains and the Collection 

of Assessment Data” on page 102. 


103



Dysfunctional 

Parenting 

7 

6 

Lower 5 

is 

“Better” 4 

3 

2 

1 

Functional 

Parenting 

Dysfunctional 

Parenting 

7 

6 

Lower 5 

is 

“Better” 

4 

3 

2 

1 

Functional 

Parenting 

� “Effect Sizes” were also calculated on these analyses (see page 103). 

o An analysis of “Effect Size” showed that on average, all parent sub‐populations 

experienced a large magnitude of change, indicating that the observed differences were 

not only statistically significant but also meaningful. 

o For the Overreactivity and Hostility subscales, there was also an interesting comparison 

between “all parents combined” and the parents who began with scores in the clinical 

range (“Clinical range at Pre‐test”). On average, effect sizes were much higher for “Clinical 

range at Pre‐test” parents, which could be used as evidence that the program has a 

stronger impact (benefit) on parents with more serious parenting issues. 

Figure 81: Parents’ Use of Positive Discipline Styles 

Overall 

3.3 3.8 3.6 3.8 3.8 3.7 3.9 3.7 3.7 

2.7 2.9 3.0 2.9 3.0 2.9 3.0 2.9 3.0 

All Parents* 

(N=158) 

3.0 

2.4 

All Parents* 

(N=159) 

Clinical 

Range at 

PreTest* 

(N=86) 

Clinical 

Range at 

PreTest* 

(N=55) 

Male* 

(N=20) 

Male* 

(N=14) 

Female* 

(N=66) 

Female* 

(N=41) 

Pre Post 

Latino* 

(N=61) 

Laxness Subscale 

Pre Post 

Latino* 

(N=39) 

Caucasian* 

(N=21) 

Caucasian* 

(N=13) 

Spanish* 

(N=44) 

Spanish* 

(N=28) 

English* 

(N=37) 

English* 

(N=25) 

Child Welfare 

Involved* 

(N=30) 

Child Welfare 

Involved* 

(N=24) 


Clinical Cut‐Off:*** 

>= 3.2 

4.2 3.9 

4.4 4.3 

4.0 

4.4 

4.1 

4.3 


Female 

>= 3.6 

Male 

2.9 2.8 2.9 2.9 2.7 2.9 2.9 3.1 >= 3.4



Dysfunctional 

Parenting 

7 

Lower 

is 

“Better” 

6 

5 

4 

3 

2 

1 

Functional 

Parenting 

Dysfunctional 

Parenting 

7 

6 

Lower 5 

is 4 

“Better” 

3 

2 

1 

Functional 

Parenting 

3.2 

2.8 

All Parents* 

(N=158) 

1.8 1.5 

All Parents* 

(N=160) 


4.8 

3.6 

Clinical 

Range at 

PreTest* 

(N=43) 

5.1 

Overreactivity Subscale 

Hostility Subscale 

Source: Triple P data from the Parenting Scale, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 




* Results marked with an asterisk had PRE/POST differences that were statistically significant at p= 4.0 

105 

Male 

>= 3.9 


Male 

>= 3.5 

Female 

>= 2.4



last 6 weeks, how confident have you felt to undertake your responsibilities as a parent?” For 

this question, scores could range from 1 to 5, with higher scores indicating more positive 

parenting experiences. 

Analyses were run to see if there was any improvement between pre and post assessments, and if 

the amount of improvement was statistically significant. 17 

As seen in the figures below, after parents participated in the program, they indicated having more 

confidence in their abilities to manage their children in difficult situations and more confidence in 

their abilities to handle difficult child behaviors. Key results include: 

� For the Parenting Tasks Checklist “Setting Self‐Efficacy” subscale, 

o Every parent sub‐population began in the clinical range, but almost all had improved 

significantly out of the clinical range by the end of the program. 

o For parents who were “Child Welfare involved,” on average they were still in the clinical 

range by the post‐assessment, but there was still significant improvement in their scores. 

� Similarly, for the Parenting Tasks Checklist “Behavioral Self‐Efficacy” subscale, 

o Every parent sub‐population began in the clinical range, but almost all had improved 

significantly out of the clinical range by the end of the program. 

o On average, parents who were male, or who were “Child Welfare involved,” were still in 

the clinical range by the post‐assessment, but for both of these sub‐populations there was 

still significant improvement in their scores. 

� For the Parenting Experience Survey, Question 3, 

o On average, all parents had significant increases in their confidence to undertake their 

responsibilities as a parent. 

o Female, Latino, and Spanish‐speaking sub‐populations also had significant increases in 

confidence in their parenting. 


o An analysis of “Effect Size” showed that on average, all parents combined, and all parent 

sub‐populations, experienced a large magnitude of change, indicating that the observed 


17 






Higher 

is 

“Better” 

Higher 

is 

“Better” 

Higher 

is 

“Better” 

Figure 82: Level of Parent Confidence 

Certain I can 

do it 

100 

80 

60 

40 

20 

0 

Certain I can't 

do it 

Certain I can 

do it 

100 

80 

60 

40 

20 

0 

Certain I can't 

do it 

90.2 

83.9 

All Parents* 

(N=176) 

84.9 

74.0 

All Parents* 

(N=176) 


Setting Self‐Efficacy 

81.2 82.6 83.0 84.4 

59.4 58.8 58.1 57.1 

Clinical 

Range at 

PreTest* 

(N=42) 

Male** Female* 

(N=34) 

Pre Post 

Latino* 

(N=33) 

Behavioral Self‐Efficacy 

Caucasian** Spanish* 

(N=28) 

Source: Triple P data from the Parenting Tasks Checklist, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 

Note: The Parenting Tasks Checklist measures confidence ratings in two factors: setting self‐efficacy and behavioral self‐efficacy. Each factor is 

comprised of 14 questions. Scores are calculated as the average of these 14 questions (unanswered questions are excluded). Higher scores indicate a 

greater degree of parenting confidence. See page 102 for a description of the sub‐populations and analyses that were run. 




Triple P Domain: Reduced levels of conflict over parenting 

This domain was measured using two different assessments: 


Parent Problem Checklist as a way to gauge changes in the level of conflict in their 

relationships due to parenting disagreements. In this scale, parents were given a range of 

parenting and relationship issues and asked to identify whether or not each issue was a 

problem for them, and the extent of the problem. Higher scores indicated a greater degree of 

conflict in the relationship. 



in the Survey is analyzed separately, and for this domain, two questions were analyzed: 

Questions 5 (“To what extent do you both agree over methods of disciplining your child?”) 

and 6 (“How supportive has your partner been towards you in your role as a parent over the 

last 6 weeks?”). For these questions, scores could range from 1 to 5, with higher scores 

indicating more positive parenting experiences. 



After completing the program, parents on average indicated that fewer parenting and relationship 

issues were actually problems. These data from parents also indicated a decrease in the extent to 

which those issues were actually viewed as problems. 

Key results include: 

� For the Parent Problem Checklist “Number of Problems” subscale, 

o On average, for all parents combined and all parent sub‐populations studied, by the end 

of the program there were significant reductions in the number of problems reported. 

o On average, however, all parent sub‐populations were still in the clinical range by the 

post‐assessment. 

� For the Parent Problem Checklist “Extent of Problems” subscale, 

o On average, for all parents combined and all parent sub‐populations studied, the extent of 

the problems was reduced by the end of the program. 

o This reduction of intensity was only statistically significant for certain populations: all 

parents combined, parents who scored in the clinical range at pre‐assessment, females, 

Latinos, and Spanish‐speaking parents. 

18 






� For the Parenting Experience Survey, Questions 5 and 6, 

o Although there was improvement in the extent to which both parents agreed over 

methods of disciplining their child, the amount of improvement was not statistically 

significant. 

o On average, there was significant improvement in the amount of support showed by the 

partners for all parents combined, Latinos, and Spanish‐speaking parents. 


All issues were a 

problem 

16 

Lower 

is 

“Better” 

o An analysis of “Effect Size” on the improvements made in the Number of Problems 

showed that on average, all parents combined, and all parent sub‐populations, 

experienced a large magnitude of change, indicating that the observed differences were 

not only statistically significant but also meaningful. 

o An analysis of “Effect Size” on the improvements made in the Extent of Problems showed 

that on average, almost all parent sub‐populations experienced a large magnitude of 

change. The Male sub‐population showed only a small effect size, and the English sub‐ 

population showed a moderate magnitude of change. 

o For the Extent of Problems subscale, there was also an interesting comparison between 

“all parents combined” and the parents who began with scores in the clinical range 

(“Clinical range at Pre‐test”). On average, effect sizes were much higher for “Clinical range 

at Pre‐test” parents, which could be used as evidence that the program has a stronger 

impact (benefit) on parents with more serious parenting issues. 

o Question 5 (“agreement over discipline method”) of the Parenting Experience Survey 

showed a moderate magnitude of change, and Question 6 (“support from partner”) 

showed a large magnitude of change for all parents and parent sub‐populations. 

Figure 83: Levels of Conflict Over Parenting 

12 

8 

4 

0 

No issues were a 

problem 

5.5 

3.5 

All Parents* 

(N=105) 


9.2 

Clinical 

Range at 

PreTest* 

(N=52) 

7.8 

5.7 5.2 

Male* 

(N=18) 

Number of Problems 

10.0 9.6 9.0 

Female* 

(N=34) 

Pre Post 

5.9 5.2 

Latino* 

(N=33) 

6.7 

Caucasian* 

(N=17) 

9.8 

Spanish* 

(N=26) 

8.7 

5.6 5.7 

English* 

(N=26) 

9.3 

7.0 

Child 

Welfare 

Involved* 

(N=20) 

109 

Clinical 

Cut‐Off: 

>5



Very much a 

problem 


96 

Lower 80 

is 

“Better” 64 

48 

32 

16 

Not at all a 

problem 

Higher 

is 

“Better” 

Higher 

is 

“Better” 

Extent of Problems 

50.5 

54.9 52.1 54.0 

48.8 

39.1 

41.8 

46.1 

31.7 38.3 37.7 38.6 37.2 38.7 39.1 37.4 

All Parents* 

(N=85) 

Clinical 

Range at 

PreTest* 

(N=45) 


(N=30) 

Pre Post 

Latino* 

(N=31) 

Caucasian 

(N=12) 

Spanish* 

(N=25) 

Source: Triple P data from the Parent Problem Checklist, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 

Note: The Parent Problem Checklist measures the number of issues that have been a PROBLEM for parents, and the EXTENT of the problem for each 

issue. Scores for the PROBLEM subscale range from 0 (no issues were a problem) to 16 (all issues were a problem). Scores for the EXTENT subscale 

range from 16 (Not at all a problem) to 112 (Very much a problem). There is no clinical cut‐off for this subscale. See page 102 for a description of the 



Higher 

is 

“Better” 



Triple P Domain: Increased support in their role as a parent 


Experience Survey as a measure of issues related to being a parent. Each question in the Survey is 

analyzed separately, and for this domain, Question 4 was analyzed (“How supported have you felt in 

your role as a parent over the last 6 weeks?”). For this question, scores could range from 1 to 5, with 

higher scores indicating more positive parenting experiences. 




� After completing the program, on average, there was significant improvement in the amount 

of support felt by all parents combined and all sub‐populations (Females, Latinos, and 

Spanish‐speaking parents). 

� “Effect Sizes” were also calculated on this analysis (see page 103), which showed that on 

average, all parents combined, and all parent sub‐populations, experienced a large 

magnitude of change, indicating that the observed differences were not only statistically 

significant but also meaningful. 

Extremely 

5 

Figure 84: Feelings of Support in Their Role as a Parent 

4 

3 

2 

1 

0 

Not at all 

Source: Triple P data from the Parenting Experience Survey, Question 4, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 

Note: The Parenting Experience Survey measures issues related to being a parent. Each question is analyzed separately, under the corresponding 

domain in this Triple P analysis. For Q1‐6, scores range from 1 to 5. For Q7, scores range from 0 to 6. Higher scores indicate more positive parenting 

experiences. There are no clinical cut‐offs for this assessment. See page 102 for a description of the sub‐populations and analyses that were run. 




Triple P Domain: Increased levels of satisfaction with their relationship 

As parents learn new ways of interacting with their children, Triple P has found that conflicts 

between partners regarding parenting decrease, and consequently, partners’ satisfaction with their 

relationship increases. Two different assessments were used to assess parents’ satisfaction with 

their relationship: 


Relationship Quality Index. For this assessment, scores are calculated by summing all six 

questions. Scores range from 6 (Very unsatisfied with relationship) to 45 (Very satisfied), with 

higher scores indicating higher satisfaction with their relationship. 



in the Survey is analyzed separately, and for this domain, Question 7 was analyzed, “In an 

overall sense, how happy do you consider your relationship with your partner to be?” For this 

question, scores could range from 0 to 6, with higher scores indicating more positive 

parenting experiences. 



As seen in the figures below, parents reported improved satisfaction in the relationship with their 

partners. Key results include: 

� For the Relationship Quality Index, 

o On average, for all parents combined and all sub‐populations (except Caucasians), there 

was significant improvement in their amount of satisfaction with their relationship by the 

end of the program. 

o However, all sub‐populations were still in the clinical range by the post‐assessment. 


o Although there was improvement in how happy they were with their relationship, the 

amount of improvement was not statistically significant. 


o For the Relationship Quality Index: 

� An analysis of “Effect Size” on the improvements made showed that on average, all 

parent sub‐populations experienced a large magnitude of change, indicating that the 

observed differences were not only statistically significant but also meaningful. 

� There was also an interesting comparison between “all parents combined” and the 

parents who began with scores in the clinical range (“Clinical range at Pre‐test”). On 

average, effect sizes were much higher for “Clinical range at Pre‐test” parents, which 

could be used as evidence that the program has a stronger impact (benefit) on 

parents with more serious parenting issues. 

o Question 7 of the Parenting Experience Survey showed moderate magnitudes of change. 

20 



112 FIRST 5 SANTA CRUZ COUNTY



Very satisfied 

with relationship 

45 

Higher 

is 

“Better” 

10 

6 5 

Very unsatisfied 

with relationship 

Higher 

is 

“Better” 

Figure 85: Level of Parents’ Satisfaction with Their Relationship 

40 

35 

30 

25 

20 

15 

33.0 

31.3 

All Parents* 

(N=126) 


Satisfaction with The Relationship 

24.5 24.6 24.5 24.2 24.9 25.0 25.2 

23.0 

18.9 18.9 18.9 18.4 19.3 18.7 19.5 20.0 

Clinical 

Range at 

PreTest* 

(N=44) 

Male* 

(N=14) 

Female* 

(N=30) 

Pre Post 

Latino* 

(N=27) 

Caucasian 

(N=10) 

Spanish* 

(N=18) 

Source: Triple P data from the Relationship Quality Index, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 

Note: The Relationship Quality Index measures parents’ level of satisfaction with their relationship. Scores are calculated by summing all six questions 

in the assessment, with total scores ranging from 6 (Very unsatisfied with relationship) to 45 (Very satisfied). See page 102 for a description of the 





Triple P Domain: Decreased levels of emotional difficulties 

This domain was measured using two different assessments: 


Depression, Anxiety, and Stress Scale – Short Version (DASS‐21), which measures distress in 

these three areas. Scores for each of these three scales range from 0 (no distress) to 42 

(extremely severe distress), with higher scores indicating greater levels of depression, 

anxiety, and stress. 



in the Survey is analyzed separately, and for this domain, Question 2 was analyzed, “To what 

extent do the following statements describe your experience as a parent in the last 6 

weeks?” Question 2 contained five statements regarding how rewarding, demanding, 

stressful, fulfilling, and depressing parenting was for them, which were averaged to create a 

total score for this question. Scores could range from 1 to 5, with higher scores indicating 

more positive parenting experiences. 



The following figures indicate that parents’ levels of emotional difficulties improved during the 

program. Key results include: 

� For the DASS‐21 “Depression” subscale, 

o All sub‐populations (except Males) made significant improvement in lowering their level 

of depression. All began within the Severe range, and ended out of a range of concern. 

� For the DASS‐21 “Anxiety” subscale, 

o All sub‐populations (except Caucasians) made significant improvement in lowering their 

level of anxiety. All began within the Severe or Very Severe range, and ended in the lower 

range of Moderate, or out of a range of concern completely. 

� For the DASS‐21 “Stress” subscale, 

o All sub‐populations made significant improvement in lowering their level of stress. All 

began within the Severe range, and ended out of a range of concern. 


o When all parents were combined, they showed significant improvement in how positively 

they described their experience as a parent by the end of the program. 

o Parent sub‐populations also made improvements, but they were not statistically 

significant. 

21 



114 FIRST 5 SANTA CRUZ COUNTY





distress 

42 

Lower 

is 

“Better” 

o An analysis of “Effect Size” on the improvements made showed that on average, all parent 

sub‐populations experienced a moderate or large magnitude of change, indicating that 

the observed differences were not only statistically significant but also meaningful. 

o For the Depression and Anxiety subscales, there was also an interesting comparison 

between “all parents combined” and the parents who began with scores in the clinical 

range (“Clinical range at Pre‐test”). On average, effect sizes were much higher for “Clinical 

range at Pre‐test” parents, which could be used as evidence that the program has a 

stronger impact (benefit) on parents with more serious parenting issues. 

o Question 2 of the Parenting Experience Survey showed large magnitudes of change. 

Figure 86: Level of Parents’ Emotional Difficulties 

35 

28 

21 

14 

7 

0 

No distress 


distress 

42 

Lower 

is 

“Better” 

35 

28 

21 

14 

7 

0 

No distress 

9.7 

5.8 

All Parents* 

(N=176) 

8.4 

4.9 

All Parents* 

(N=176) 


24.0 

10.8 

Clinical 

Range at 

PreTest* 

(N=48) 

21.3 

14.0 

Depression 

24.9 24.6 23.0 24.6 22.7 24.4 

9.8 


(N=36) 

19.7 21.1 19.3 20.7 

9.6 

Clinical 

Range at 

PreTest* 

(N=63) 

11.6 

Male* 

(N=14) 

Female* 

(N=49) 

Pre Post 


Latino* 

(N=38) 

Anxiety 

Pre Post 

9.0 8.6 

Latino* 

(N=47) 

9.8 

Caucasian* 

(N=8) 

17.1 

13.1 

Caucasian 

(N=14) 


Spanish* 

(N=31) 

21.0 

7.4 

Spanish* 

(N=38) 

8.1 

English* 

(N=14) 

17.8 

English* 

(N=22) 


Child 

Welfare 

Involved* 

(N=16) 

18.8 

11.5 11.7 

Child 

Welfare 

Involved* 

(N=24) 


Clinical 

Cut‐offs: 


Severe >= 21 

Moderate >=14 

Clinical Cut‐offs: 


Severe >=15 

Moderate >=10




distress 

42 

Lower 

is 

“Better” 

35 

28 

21 

14 

7 

0 

No distress 

Extremely positive 

5 

Higher 

is 

“Better” 

12.9 

7.8 

All Parents* 

(N=175) 

Stress 

28.8 26.0 29.4 29.7 26.3 29.9 27.5 26.5 

12.2 

Clinical 

Range at 

PreTest* 

(N=42) 

9.0 

Male* (N=8) Female* 

(N=34) 

12.9 11.7 

Latino* 

(N=30) 

Source: Triple P data from the Depression, Anxiety, and Stress Scale – Short Version (DASS‐21), collected and analyzed by Applied Survey Research, 

Jan. 2010 ‐ June 2011. 

Note: The Depression, Anxiety, and Stress Scale – Short Version (DASS‐21) measures distress along 3 scales: Depression, Anxiety, Stress. Scores for 

each scale are calculated by summing the participants’ responses for each of the 21 items. Higher scores on each of the scales indicate greater levels 

of depression, anxiety, and stress. Each scale has different clinical cut‐offs for the 5 severity levels: normal, mild, moderate, severe, and extremely 

severe. See page 102 for a description of the sub‐populations and analyses that were run. 


Moderate >=19



Triple P Domain: Improvements in child behavior 



of the relationship. This domain was measured using three different assessments: 

� Parents participating in Level 4 of the Triple P Program were asked to complete the Eyberg 

Child Behavior Inventory (ECBI), a pre and post assessment of the frequency with which 

certain child behaviors occur (Intensity subscale), and the extent to which parents view those 

behaviors to be a problem (Problem subscale). Intensity scores could range from 36 (Never 

occurs) to 252 (Always occurs), and Problem scores ranged from 0 (No) to 36 (Yes), with 

higher scores indicating greater frequencies of problem behaviors and greater likelihood that 

these behaviors were a problem to the parent. 



in the Survey is analyzed separately, and for this domain, Question 1 was analyzed, “In an 

overall sense, how difficult has your child’s behavior been over the last 6 weeks?” Scores 

could range from 1 to 5, and for this question the scale was reversed so that higher scores 

indicated more positive parenting experiences. 

� Parents who participated in Level 4 of the Triple P program and who received services from 

the Health Services Agency ‐ Children's Mental Health completed the Child Behavior Checklist 

which is a screening tool used to assess behavioral and emotional problems in children and 

adolescents. It contains about 100 items that can cluster into several syndromes, 

competence scales, and codes from the Diagnostic and Statistical Manual of Mental 

Disorders, 4th Edition (DSM‐IV). Children are ranked according to the severity of certain 

problems, thus percentile rankings show how a child compares to the general population. A 

significant improvement in percentile rank indicates a decrease in clinical risk. 



As seen in the following figures, after completing the Triple P Program, fewer parents viewed their 

children’s behavior as problematic, and parents also reported fewer problematic child behaviors as 

actually being a problem for them. Key results include: 

� For the ECBI “Intensity” subscale, 

o On average, for all parents combined and all parent sub‐populations, there was a 

significant reduction in the frequency of potentially problematic child behaviors. On 

average, these parents began with scores within the clinical range, and ended with scores 

that were out of the clinical range. 

22 




117



Lower 

is 

“Better” 

� For the ECBI “Problem” subscale, 

o For all sub‐populations, there was a significant reduction in the number of child behaviors 

that were perceived to be a problem. On average, these parents began with scores within 

the clinical range, and ended with scores that were out of the clinical range (parents 

involved in Child Welfare were within 1/10 th of a point of being out of the clinical range). 


o On average, for all parents combined and all sub‐populations, there was significant 

reduction in how difficult their child’s behavior had been. 

� For the Child Behavior Checklist, 

o Parents reported significant improvements in their children’s problematic behaviors in 

both Internalizing and Externalizing Syndromes, as well as in all Syndromes overall. 

o There were significant improvements in two DSM disorders: Anxiety and Oppositional. 

o There was a significant improvement in children’s social competence behaviors. 


o An analysis of “Effect Size” on all the improvements made showed that on average, all 

parents combined and all parent sub‐populations experienced a large magnitude of 

change, indicating that the observed differences were not only statistically significant but 

also meaningful. 


Behavior always 

occurs 

252 

216 

180 

144 

108 

72 

36 

Behavior 

never occurs 

120.6 

92.6 

All Parents* 

(N=144) 

Frequency of Potentially Problematic Child Behaviors 

164.0 151.3 167.1 

Clinical Range 

at PreTest* 

(N=57) 

114.0 118.2 113.0 111.9 

Male* 

(N=11) 

Female* 

(N=46) 

Pre Post 

164.8 161.0 164.7 162.3 162.5 

Latino* 

(N=45) 

118 FIRST 5 SANTA CRUZ COUNTY 

122.0 

Caucasian* 

(N=12) 

110.6 

Spanish* 

(N=34) 

120.1 

English* 

(N=21) 

129.4 

Child Welfare 

Involved* 

(N=16) 

Clinical 

Cut‐off: 

>=131




a problem 

36 

Lower 

is 

“Better” 

30 

24 

18 

12 

6 

0 

No behaviors 



5 

Higher 

is 

“Better” 

15.0 

8.2 


23.0 


20.4 

23.5 24.1 

12.6 11.9 12.7 13.0 

Source: Triple P data from the Eyberg Child Behavior Inventory, collected and analyzed by Applied Survey Research, Jan. 2010 ‐ June 2011. 








Additional Triple P Studies and Client Data Collection 

Child Welfare Study: Possible effects of Triple P participation on future child 

welfare allegations 

Among families who have experienced child abuse or neglect, participation in the Triple P program 

was expected to be associated with lower rates of future child welfare allegations. To examine 

whether associations were observed between Triple P participation and improved child welfare 

outcomes in these Santa Cruz County families, outcome data for two groups of parents who entered 

(or re‐entered) the child welfare system were compared, including: (1) parents who received the 

Triple P intervention; and (2) parents who were enrolled in a model of parenting education offered 

prior to the initiation of the Triple P program. Both programs were offered through a local 

community‐based organization called the Parents Center. 

The following research question was examined: 

� To what extent is Triple P participation associated with lower rates of new substantiated 

child maltreatment allegations, compared to participants in other parenting programs? 

To determine whether participation in Triple P was associated with lower rates of new substantiated 

child maltreatment allegations, parents’ child welfare records were examined at two time periods: 

within the first six months after their program started and in the period from 6 to 12 months after 

beginning the program (as there was a low number of families at the 12 month time period, only the 

6 month results are reported at this point). Rates were compared for Triple P participants and 

participants in the comparison parenting program. 

The following figure shows the rates of new substantiated cases of child maltreatment within the 

first six months of parents’ participation in either Triple P or the comparison parenting program. 

� After six months, parents in the comparison parenting program were more than three and a 

half times more likely than Triple P participants to have had a new substantiated 

maltreatment allegation. 

Figure 88: Participants with a Substantiated Allegation of Child Maltreatment Occurring 

Up to 6 Months after Program Entry 

20% 

15% 

10% 

5% 

1.4% 

0% 

Triple P Participants Comparison Group 

Source: Applied Survey Research, Triple P – Santa Cruz County: Special Exploratory Study to Assess Child Welfare Outcomes, 2011. 

N: 70 Triple P participants and 137 comparison group participants. 

Results suggest that Triple P is associated with reductions in future child abuse and neglect. A re‐ 

examination of these data at a later date, when more participants have reached the 6‐ and 

12‐month time periods, may provide a better measurement of the program’s impact on outcomes 

that are themselves fairly low‐frequency events. 


5.1%



Satisfaction with Services 

Satisfaction Surveys (Jan. 2010 – June 2011) 

All parents in the Triple P program (except those attending brief Level 2 Individual sessions) were 

asked to complete a self‐administered satisfaction survey upon completing their services. 

� Parents participating in Levels 3 (multi‐session) and Levels 4 and 5 of the Triple P Program 

filled out a Parent Satisfaction Survey with 13 questions using a 7‐point scale (with 7 

indicating highest satisfaction), and 3 open‐ended questions. Key results include: 

o Over half (55%) of Triple P parents who responded to the survey indicated that they were 

very satisfied with their overall program experience. 

o The average parent satisfaction ratings ranged from 5.30 to 6.51, on the 7‐point scale. 

Most parents felt that the program met their needs, as well as the needs of their children, 

offered the help that they needed, and if they needed help in the future, they would 

return to Triple P. 

� Parents participating in the Level 2 Seminars and Level 3 Workshops filled out a shorter 

Satisfaction Survey with 3 questions using a 5‐point scale (with 1=Disagree, and 5=Agree), 

and 1 open‐ended question. 

o Almost three‐fourths (72%) of Triple P parents who participated in the seminars and 

workshops and who responded to the survey indicated that they were very satisfied with 

their overall program experience. 


Most parents felt that the program answered their questions, that they would continue to 

use the tip sheets, and were very satisfied with the services they received. 

Figure 89: Parents’ Satisfaction with the Triple P Program: Levels 3 (Multi-session), 

and Levels 4 and 5 

100% 

80% 

60% 

40% 

20% 

0% 


Overall Satisfaction, by Response Option 

1.4% 0.4% 2.0% 3.1% 

16.4% 

22.1% 

1 2 3 4 5 6 7 

Lowest 

Satisfaction 

Response Options 

54.6% 

Highest 

Satisfaction 



N = 198 respondents with a total of 2,509 responses. 

121



1. How would you rate the quality of the service you and your 


2. Did you receive the type of help you wanted from the 

program? (N=196) 

3. To what extent has the program met your child's needs? 

(N=196) 


5. How satisfied were you with the amount of help you and your 



your child's behavior? (N=198) 





9. In an overall sense, how satisfied are you with the program 

you and your child received? (N=191) 



11. Has the program helped you to develop skills that can be 

applied to other family members? (N=193) 

12. In your opinion, how is your child's behavior at this point? 

(N=192) 

13. How would you describe your feelings at this point about 

your child's progress? (N=192) 

Average Ratings of Various Program Aspects 



Figure 90: Parents’Satisfaction with the Triple P Seminars/Workshops 

100% 

80% 

60% 

40% 

20% 

0% 

Overall Satisfaction with Seminars/Workshops, by Response Option 

0.3% 0.4% 4.7% 


Note: 1=Disagree, and 5=Agree. 

N = 254 respondents with a total of 760 responses. 


5.30 

5.91 

5.88 

6.11 

6.07 

6.06 

6.47 

6.34 

6.51 

6.40 

6.35 

6.43 

6.33 

1 2 3 4 5 6 7 

23.0% 

1 2 3 4 5 

Lowest 

Satisfaction 

Response Options 

71.6% 

Highest 

Satisfaction



1. The seminar/workshop answered a question or concern I have 

had about parenting. (N=254) 


Average Ratings of Various Seminar/Workshop Aspects 

2. I am likely to use some of the parenting strategies in the tip 

sheet. (N=253) 



Requests for Further Services 

During 2010‐11, 12 Level 2 seminars were provided to 96 participants, and 50 Level 3 workshops 

were provided to 336 participants. Of these participants, 21% requested follow‐up services, 

suggesting that these brief Triple P seminars and workshops help some families find additional 

parenting resources, and may be an effective way of giving participants a chance to try out the 

Triple program, getting them interested, and giving them an opportunity to participate in further 

services. 

Follow-Up Survey: Maintenance of parenting knowledge and practices gained 

from Triple P 

Parents and guardians who completed certain Triple P programs were given the option of voluntarily 

participating in a follow‐up phone survey six months later, to help determine the long‐lasting effects of 

these programs on their parenting skills and experiences. This survey consisted of 18 questions, some 

with multiple parts, that asked about their parenting abilities and effectiveness in dealing with certain 

parenting problems, their confidence in their parenting skills, the Triple P strategies that they are 

currently using, changes in their child’s behavior, and where applicable, their relationship with and 

support from their partner. Participants were also given the option of commenting on their experience 

with the program. Parents were assured that the survey was confidential, and that their individual 

responses would be kept anonymous and reported as a summary with other data. Participants who 

completed the survey were given a $25 gift certificate to Target. 


3. Overall I was satisfied with the workshop. (N=253) 

� Results showed that around six months after completing Triple P services, parents are 

reporting high levels of parenting skills, confidence, and support (measured using questions 

from the Parenting Experience Survey). 

As more parents complete the Triple P program, it may be possible to compare their “six‐ 

month follow‐up” parenting skills with similar data collected at the beginning (Pre) and very 

end of their services (Post). 

123 

4.53 

4.74 

4.68 

1 2 3 4 5




5 

Higher 

is 

“Better” 

0 

Extremely Difficult 

� Additional survey results indicate that six months after their Triple P services, parents feel 

highly effective in dealing with their children’s behavior, and report improved child behavior 

overall. 

Figure 91: Levels of Parenting Difficulty Six Months After Triple P Services 

4 

3 

2 

1 

3.58 



4.21 4.23 

Q2: Parental 


Q3: Parenting 


3.62 3.50 

Q4: Parental Support Q5: Partner Support 

(N=26) Over Methods of 


Figure 92: Parenting Difficulty Six Months After Triple P Services: 

Frequency of Each Response Option 

20 

15 

10 

5 

0 

3 


6 

4 

2 2 

1 



2 

9 

13 

Q2: Parental 


1 

1 

Source: Triple P data from the Parenting Experience Survey, collected and analyzed by Applied Survey Research, 2011. 

Note: The Parenting Experience Survey measures issues related to being a parent. Each question is analyzed separately, and correspond to different 

Triple P domains examined in this report section. For Q1‐6, scores range from 1 to 5. Q7 was not asked in the follow‐up survey. Higher scores indicate 

more positive parenting experiences. There are no clinical cut‐offs for this assessment. 

* Question 2 results are averages of the 5 items in this question. 


15 

9 

Q3: Parenting 


2 

3 

1 (Extremely a Problem) 

3 

13 

5 

Q4: Parental Support 

(N=26) 

2 (Very Much a Problem) 

3 (Moderately A Problem) 

4 (Slightly a Problem) 

5 (Not At All A Problem) 

2 

7 

7 

2 

Q5: Partner Support 

Over Methods of 


3.83 

Q6: Parenting 

Support from 

Partner (N=18) 

3 

2 

8 

5 

Q6: Parenting 

Support from Partner 

(N=18)



Building a Population‐Based System of Parent Education 

Triple P Practitioners 

Between 2009 and June 30, 2011, 20 agencies and 4 independent practitioners in Santa Cruz County 

have been providing Triple P services to clients. Participating agencies were those that provide a 

range of services for families, such as mental health counseling, early education, health care, case 

management, and support for victims of domestic violence and sexual assault: 

� Community Bridges ‐ La Manzana 

Community Resources 

� Community Bridges ‐ Roots & Wings 

� Dominican Hospital ‐ Outreach 

� Familia Center 

� First 5 Santa Cruz County 

� Health Services Agency ‐ Children's 

Mental Health 

� Health Services Agency ‐ South County 

Clinic 

� Human Services Department ‐ 

Employment & Benefit Services 

� Human Services Department ‐ Family 

& Children's Services 

� MidPeninsula Housing – Services 

Corporation 


� Mountain Community Resources 

� Optimal Solutions Consulting 

� Parents Center 

� Santa Cruz Community Counseling Center – 



Head Start 


Youth Services 


Primeros Pasos 

� Santa Cruz Women's Health Center 

� Women's Crisis Support ~ Defensa de 

Mujeres 

� YWCA Watsonville 

Agency staff and independent practitioners attended workshops to become trained and accredited 

practitioners of the Triple P Program, and many of these practitioners were trained in multiple 

levels. Since 2009, a total of 86 practitioners have been accredited to provide Triple P services. 

Figure 93: Number of Practitioners Trained and Accredited with Triple P (2009-11) 

COURSE TYPE 

NUMBER OF 

TRAINING COURSES 

CONDUCTED 

TRAINING ACCREDITATION 

NUMBER OF 

PRACTITIONERS 

TRAINED 

NUMBER OF 

ACCREDITATION 

COURSES CONDUCTED 

NUMBER OF 

PRACTITIONERS 

ACCREDITED 

L2 Seminars 1 20 1 20 

L3 Primary Care 3 58 3 53 

L3 Primary Care ‐ Special Accreditation 1 6 (Quiz Only) 5 

L4 Group 2 40 2 38 

L4 Standard 2 37 2 37 

L5 Enhanced 1 18 1 18 

L5 Pathways 1 18 1 18 

Total Number of Courses 11 10 

Total Number of Practitioners (unduplicated) 94 86 

Source: Optimal Solutions Consulting, Triple P Practitioner Training Data, 2009‐2011. 

125



Efficacy of Staff Training on Triple P 

In addition to offering structured trainings to practitioners, Triple P America also provides measures 

to assess the effectiveness of such trainings. The first measure is a Parent Consultation Skills 

Checklist (PCSC), an instrument to gauge changes in practitioners’ ability and confidence to conduct 

parent consultations. The second instrument is a Workshop Evaluation Survey that measures 

practitioners’ satisfactions with the trainings. These data are described below. 

Changes in self‐efficacy related to parent consultation 

The Parent Consultation Skills Checklist (PCSC) was used to measure practitioners’ self‐efficacy, or 

perceived competency, in core skills including assessment, active skills training, dealing with process 

issues, and clinical application of positive parenting strategies. 

Practitioners rated their proficiency on a 7‐point scale (1 = not at all confident or definitely not 

adequately trained, 7 = very confident or definitely adequately trained). The questionnaire was 

administered prior to beginning training (Pre), immediately after training (Post), and at the end of 

accreditation (Follow‐up). 

Results indicate that during 2010‐11, participants’ ratings of self‐efficacy increased from pre to post 

training across all levels, and improvements were maintained or were higher at follow‐up. The only 

exception was a slight decrease in pre‐post ratings of “Adequately Trained in Parent Consultations” 

and “Confidence in Conducting Parent Consultations” for the Level 4 Group training, although for 

both there was an increase by the time of their follow‐up ratings. The mean ratings for all levels of 

trainings and accreditations are summarized below. 

Figure 94: Summary of Parent Consultation Skills Checklist Ratings (2010-11) 

ADEQUATELY TRAINED IN 

PARENT CONSULTATIONS 

CONFIDENCE IN CONDUCTING 

PARENT CONSULTATIONS 

OVERALL PROFICIENCY IN PARENT 

CONSULTATION SKILLS 

LEVEL OF TRIPLE P Pre Post Follow‐up Pre Post Follow‐up Pre Post Follow‐up 

Level 2 Seminar 5.41 6.35 6.18 5.47 5.82 5.82 5.22 5.91 5.92 

Level 3 Primary Care 4.15 5.23 6.00 4.15 4.77 5.69 3.90 4.92 5.68 

Level 4 Group 5.93 5.67 6.60 6.00 5.23 6.43 5.59 5.69 6.27 

Level 4 Standard 4.23 6.23 6.54 4.00 6.15 6.31 4.69 6.07 6.53 

Source: Triple P America and Optimal Solutions Consulting, 2011. 

Satisfaction with Training 

Participants completed a Workshop Evaluation Survey at the end of each training and on completion 

of the accreditation process. The survey included a 7‐point scale (1 = low, 7 = high) to assess: 

� Quality of the training course 

� Whether the amount of active participation within the course was appropriate 

� Quality of the content of the training 

� Whether respondents felt they had the skills to implement the program, and 

� Overall satisfaction with the training course 




On average, participants were highly satisfied with the quality and content of all levels of Triple P 

trainings and accreditation workshops, during 2010‐11. The mean ratings for all levels of trainings 

and accreditations are summarized in the figure below. 

Figure 95: Summary of Training Evaluation Survey Ratings (2010-11) 


QUALITY OF PRESENTATION WORKSHOP CONTENT OVERALL SATISFACTION 

LEVEL OF TRIPLE P Training Accreditation Training Accreditation Training Accreditation 

Level 2 Seminar 6.32 6.41 6.26 6.59 6.42 6.29 

Level 3 Primary Care 6.13 6.23 6.13 6.15 5.73 6.15 

Level 4 Group 6.39 6.53 6.28 6.47 6.06 6.11 

Level 4 Standard 6.50 6.56 6.25 6.56 6.44 6.50 

Source: Triple P America and Optimal Solutions Consulting, 2011. 

Alignment of referral, billing, and data sharing processes across the network of 

agencies who support Triple P 

Referral System 

By the end of FY 2010‐11, 86 practitioners (unduplicated count) from 20 agencies and programs had 

been accredited to provide Triple P services. As the number of practitioners expanded, First 5 

implemented the following steps to build and enhance the Triple P referral system: 

� Maintained and distributed a contact list indicating which organizations have practitioners 

accredited in each Level of Triple P. 

� Disseminated flyers and descriptions of Triple P Seminars, Workshops, and Groups to service 

providers as a means to encourage referrals. 

� Publicized Triple P services in print and online editions of newspapers and community 

calendars. 

� Established First 5’s main phone number as a “warmline.” This number was publicized in all 

flyers, emails and media announcements as a central place to receive assistance locating 

Triple P services. First 5 staff were trained to conduct a brief screening in order to assess 

callers’ needs and make appropriate referrals. 

� Developed Triple P business cards containing First 5’s warmline and website address, as well 

as space for practitioners to insert their own contact information. 

� Enhanced First 5’s website to include information about Triple P, accredited practitioners, 

referral processes, and a master calendar of Triple P Groups, Workshops, and Seminars. 

127



Billing and Funding 

First 5, Health Services Agency (Children’s Mental Health), and the Human Services Department 

established a collaborative system for funding Triple P trainings, parent resources, and services. 

� Children’s Mental Health contracted with First 5 to implement Prevention and Early 

Intervention strategies in the Mental Health Services Act (MHSA) Plan, including the 

coordination and implementation of Triple P. 

� In FY 2010‐11, the Human Services Department contracted with First 5 to provide Triple P 

trainings that qualified for partial reimbursement from Federal Title IV‐E training funds. First 

5 provided the required match, enabling the Human Services Department to access $82,226 

in Title IV‐E funds. The reimbursement was passed through to First 5 to help cover training 

costs, which allowed more resources to be directed toward service provision. 

� First 5 blended its own resources with funds from Children’s Mental Health and the Title IV‐E 

reimbursement to contract with Triple P America and organizations providing specific Triple P 

services. This blended funding strategy streamlined billing procedures and reporting 

requirements, which allowed resources to be used in a more flexible and coordinated manner. 

� Agencies that provided mental health services billed Medi‐Cal EPSDT. 

� Families in the Child Welfare System received services funded from a contract between the 

Human Services Department (HSD) and the Parents Center. 

� Individual practitioners billed clients’ private insurance. 

� Medical offices are beginning to explore billing health insurance for parent education. 

Data Sharing 

First 5 and Applied Survey Research (ASR) developed evaluation protocols and forms for each level 

of Triple P services. Practitioners were trained to obtain parents’ informed consent to participate in 

the evaluation of the Triple P program, collect the required intake and assessment data, and submit 

the data to ASR on a monthly basis. Specific protocols were established to protect the privacy and 

confidentiality of parents participating in Triple P services. 

ASR also developed an Excel‐based scoring application that enabled practitioners to enter and 

summarize parents’ assessment data quickly and accurately. Practitioners used the assessment data 

to help parents set goals for change, then submitted data electronically to ASR (maintaining client 

anonymity) for further analysis. 



Side-by-Side 



STRONG FAMILIES – SIDE‐BY‐SIDE 

The Side‐by‐Side: Early Childhood Mental Health Access Program, launched in March 2010, was 

created to address the significant need for early mental health services for families with children 

between 0‐5 years of age. The program has expanded early childhood mental health services and 

provides intervention services to families who have children showing early signs of social/emotional 

difficulty. The program also provides guidance and consultation about social/emotional and mental 

health needs of infants and young children to early childhood educators. The program strives to 

support the working relationship between families and child care providers/preschool staff. 

Parents can elect to receive only “Site‐based” services for their children (i.e., classroom 

observations, in‐class intervention, and teacher consultations) or a combination of “Site‐based” and 

“Family services” (i.e., classroom observations, in‐class intervention, teacher consultations, 

individual/family counseling, and assistance from the Family Resource Specialist, if needed). Since 

the Ages & Stages Questionnaires (ASQ) and the Child Behavior Checklist (CBCL) are completed by 

parents, only parents who are participating in “Family services” fill out these assessments. For the 

children who are receiving “Site‐based” services only, Side‐by‐Side Clinician/Consultants provide 

recommendations to teachers and additional follow‐up, as needed. 

“The childcare/pre-school staff have told us that our services have been helpful to them. … They report 

that the ideas and suggestions we shared with them have improved the children’s social/emotional 

functioning in class, and made their jobs more satisfying.” 

One family’s story: 

“Ryan* began attending this center about a month before [services began], right after having been 

expelled from a different center. At the previous center, Ryan had been highly aggressive, very defiant 

and argumentative, and quite disruptive. Many of the children were afraid of Ryan, and no one would 

play with him. None of the teacher’s interventions helped improve Ryan’s conduct. 

Ryan made significant social/emotional gains at the center during the period of time he was 

involved with our program. His aggression decreased dramatically. He became much less 

argumentative and much more cooperative. Ryan also became able to participate fully in 

the classroom activities, and required less time to transition between them. Ryan improved his ability 

to express his distress in words rather than demonstrating it in problematic ways through actions. He 

also recovers from being upset much more quickly now. 

Perhaps more importantly, Ryan has made friends with a few children in class who seek out his 

companionship. He also appears much happier, more relaxed, and more playful. At the beginning of 

my work at the center, the teachers expressed great concerns that Ryan would not be socially and/or 

emotionally ready to attend Kindergarten in the fall. Now, they all feel confident that he will.” 

-Side-by-Side, Annual Progress Report 


129






SITE‐BASED SERVICES FAMILY SERVICES TOTAL 

Children 34 7 41 

Source: (Parents/Guardians) Side by Side 2010‐11 Annual Progress Report; (Children) SUN database/CCD data for July 1, 2010 – June 30, 2011. 

Note: See “Program Description” for a description of “Site‐based” and “Family” services. 

Program Development 


Staff/Child Care Providers 67 

Classrooms 22 

Source: Side by Side 2010‐11 Annual Progress Report. 

Outcome Objective: Children participating in “Family Services” will receive 

developmental screening and be assessed for behavioral and 

emotional problems 

90% of the families who participate in the program will complete the ASQ and CBCL. 


ASQ (DEVELOPMENTAL SCREENING) 100% 


N=7 

CBCL (ASSESSMENT FOR BEHAVIORAL AND EMOTIONAL PROBLEMS) 85.7% 


Note: Results should be interpreted with caution due to the low number of cases. 

Families participating in “Family Services” received initial screenings and assessments. 

� All families who began receiving “Family‐services” in 2010‐11 completed evidence‐based 

screenings about their child, using the ASQ. 

� Six of the seven families also completed the initial CBCL. 

� Family needs assessments were completed with all of the families, and follow‐up assistance 

was provided when necessary. 

N=7




Outcome Objective: Children participating in “Site-based” services will have their 

needs evaluated and addressed 

For children who participated in “Site‐based” services only, Side‐by‐Side Clinician/Consultants 

observed all these children in their classroom settings, and then had consultations with the 

childcare/pre‐school staff. The Clinician/Consultants individualized the services they provided, 

varying the number of classroom observations and consultations depending on the needs of the 

child and the staff. 

The recommendations that were provided to the staff tended to fall into the following categories: 

� Modifying the classroom structure, routine, and ambiance. 

� Changing the staff’s expectations of the child. 

� Altering the staff’s communication and interaction style with the child. 

� Implementing various strategies to address classroom challenges such as: defiance, 

aggression, disruptiveness, angry outbursts, argumentativeness, cursing, intimidation, and 

tantrums. 

The Clinician/Consultants later followed up with the staff about the impact and effectiveness of the 

recommendations that were made. 


Outcome Objective: Families participating in “Family Services” will report 

improvements in child behavior 

1. 85% of eligible families completing between 8‐12 psychotherapy/counseling meetings will 

complete the Child Behavior Checklist (CBCL) as a pre/post intervention measure. 

2. Of those completing both a pre and post CBCL, 75% will demonstrate improvement in at 

least one measure on the CBCL. 




Two out of the seven families that began “Family‐services” this period completed between 8‐12 

psychotherapy/counseling sessions. Both of the families (100%) completed the CBCL as a pre/post 

intervention measure. 

� The post‐intervention scores on CBCL indicate that both of the children (100%) made 

improvements in their conduct and functioning in at least one of the assessment’s domain 

areas. 

� In actuality, both children made even greater improvement: 

o One of the children’s scores reflected improvements in 12 out of the 12 domains. 

o The other child’s score reflected improvements in 11 out of the 12 domains. 

100% 

131 

N=2 

100% 

N=2


STRONG FAMILIES – LA MANZANA COMMUNITY RESOURCES 

La Manzana Community Resources 


La Manzana Community Resources (LMCR) provides brief case management and information and 

referrals for vulnerable families with children ages 0‐5 to improve families’ access to services, 

enhancement of parenting skills, and awareness of community literacy activities. Additionally, LMCR 

provides access to a range of activities, workshops, and classes to ensure children are living in 

literacy‐rich environments that are supportive of their cognitive development. LMCR also provides 

parents of children ages 0‐5 with Positive Parenting Program (Triple P) education county‐wide. 


Information and Referral Services 


(Information and Referral Services) 


Children 1,332 


Parent/Guardian Participation in Triple P Services (Estimated) 


(Triple P)* 



(ages 6‐16) 204 




16.1% 

13.2% 

16.3% 

3.3% 

51.2% 

Level 2 Seminar 


Level 3 Primary Care 

Level 4 Group 

Level 4 Standard 

Source: LMCR Annual Progress Report, 2011. 

Notes: These are estimated percentages, as the data may include duplicated clients from program levels that do not collect CCDs, and also exclude 

clients who did not consent to have their assessment data included in this evaluation. Exact participation data are only available for levels of services 

where parents provided enough personal information to be able to create a Unique ID (Level 2 Individual, Level 3 Primary Care, and Level 4). Parents 

who participated in seminars and workshops did not provide enough personal information to be able to create a Unique ID, so it was not possible to 

track whether they also participated in additional levels of service. 

N= 516 (see notes, above). 





Outcome Objective: Families will be provided with information and referrals to 

meet their needs 

Type of I&R Service 

Number of Units of 

Service provided in 

2010‐2011 Type of I&R Service 

Number of Units of 

Service provided in 


Food Stamps 358 Passports 65 

Medi‐Cal 344 Health Care 52 

State Disability/ Paid Family Leave 243 Translations 52 

General Forms & Services 206 Childcare and Education 31 

Healthy Families 138 Employment Development 28 

Housing 107 

Birth Certificate Correction 

Affidavits 24 

Cash‐Aid / Cal‐Works 86 Economic Justice Project 13 

CARE/HEAP/Lifeline programs 72 SSI/SSD 13 

Healthy Kids 71 Child Support 12 

Source: LMCR Biannual and Annual Progress Reports, 2010‐11. 

Total 1,915 

Outcome Objective: Families will be assisted in developing literacy-rich 

environments 

Families with children birth‐5 were connected to a range of activities, workshops and classes to 

ensure children are living in literacy‐rich environments supportive of cognitive development. 

Type of Activity/Class 

Number of Parents Connected to 

this Activity/Class 

Child Development Resource Center 302 

Triple P 516 

Library Literacy Programs 187 

Literacy Classes (Plaza Comunitaria) 154 

Play & Learn 91 

Head Start 3 

PAPÁs 2 

Total 1,255 

Source: LMCR Annual Progress Report, 2011. 

133



Outcome Objective: Families will be provided with parenting information and 

family support 

“LMCR has been able to reach out to families who—prior to Triple P—may not have sought our services. We are able to not only 

connect them to a program that can help improve their relationship with their children, but we can offer a breadth of services 

that may help them improve their overall quality of life. 

Through Triple P, we’ve been able to partner with agencies that we had not partnered with before, which also improves our reach 

to Pajaro Valley residents. Those partnerships can prove to be invaluable resources for families in need.” 

-LMCR, Annual Progress Report 

Parents increased their use of positive discipline styles 


Scale as a pre and post assessment of their style of discipline, such as being lax, over‐reactive, or 

hostile. Scores could range from 1 (positive parenting) to 7 (ineffective parenting), with lower scores 

indicating more positive styles of discipline. 



Dysfunctional 

Parenting 

7 

6 

5 

Lower 

is 4 

“Better” 

3 

2 

1 

� As seen in the figure below, there was significant improvement from pre to post assessment 

regarding parents’ overall style of discipline, indicating their parenting style became less lax, 

less over‐reactive, and less hostile though the course of the Triple P program. 

� On average, all parents combined and all parent sub‐populations that were assessed began in 

the clinical range, but had achieved positive styles of discipline by the post‐assessment. 

Functional 

Parenting 

Figure 97: Parents’ Use of Positive Discipline Styles: Overall 

3.4 

All Parents* 

(N=70) 

3.8 3.7 3.8 3.8 3.8 3.7 

2.8 3.0 3.0 3.0 3.0 3.0 2.9 


at PreTest* 

(N=45) 

Male* 

(N=8) 

Female* 

(N=37) 

Pre Post 

Latino* 

(N=41) 


(N=33) 

English* 

(N=9) 

Source: Triple P data from the Parenting Scale, collected and analyzed by Applied Survey Research, 2011. 




* Results marked with an asterisk had PRE/POST differences that were statistically significant at p= 3.2


Parents reported improved child behavior 





of the relationship. For parents participating in Level 4 of the Triple P Program, LMCR measured this 

objective using the Eyberg Child Behavior Inventory (ECBI), a pre and post assessment of the 

frequency with which certain child behaviors occur (Intensity subscale), and the extent to which 

parents view those behaviors to be a problem (Problem subscale). Intensity scores could range from 

36 (Never occurs) to 252 (Always occurs), and Problem scores ranged from 0 (No) to 36 (Yes), with 

higher scores indicating greater frequencies of problem behaviors and greater likelihood that these 

behaviors were a problem to the parent. 



As seen in the following figures, after completing the Triple P Program, fewer parents viewed their 

children’s behavior as problematic, and parents also reported fewer problematic child behaviors as 

actually being a problem for them. Key results include: 

� For the ECBI “Intensity” subscale, 

o For all parents overall, and all sub‐populations (with enough cases to analyze), there was a 

significant reduction in the frequency of potentially problematic child behaviors. On average, 

these parents began with scores within the clinical range, and ended with scores that were out 

of the clinical range. 

� For the ECBI “Problem” subscale, 

o For all sub‐populations, there was a significant reduction in the number of child behaviors 

that were perceived to be a problem. On average, these parents began with scores within 

the clinical range, and ended with scores that were out of the clinical range. 

24 



135



Lower 

is 

“Better” 


Behavior always 

occurs 

252 

216 

180 

144 

108 

72 

36 

Behavior 

never occurs 


a problem 

36 

Lower 

is 

“Better” 

30 

24 

18 

12 

6 

0 

No behaviors 


128.4 

92.2 

All Parents* 

(N=69) 

17.7 

9.4 

All Parents* 

(N=64) 

Frequency of Potentially Problematic Child Behaviors 

168.2 154.6 172.0 166.8 165.2 


at PreTest* 

(N=32) 

24.1 

112.4 108.1 

Male* 

(N=7) 

Female* 

(N=25) 

Pre Post 

113.6 110.4 107.5 

Latino* 

(N=30) 


(N=24) 


12.2 


at PreTest* 

(N=39) 

22.0 

9.6 

Male* 

(N=5) 

24.4 

Female* 

(N=34) 

Pre Post 

24.1 24.0 24.4 

12.6 12.1 12.8 

Latino* 

(N=35) 


(N=30) 

English** 

Source: Triple P data from the Eyberg Child Behavior Inventory, collected and analyzed by Applied Survey Research, 2011. 






Clinical 

Cut‐off: 

>=131


Parents Reported High Satisfaction with Services 



All parents receiving Triple P services (except those attending brief Level 2 Individual sessions) were 

asked to complete a self‐administered satisfaction survey upon completing their services. 

� Parents participating in Levels 3 (multi‐session), 4, and 5 of the Triple P Program filled out a 

Parent Satisfaction Survey with 13 questions using a 7‐point scale (with 7 indicating highest 

satisfaction), and 3 open‐ended questions. Key results include: 


Most parents felt that the program met their needs, as well as the needs of their children, 

offered the help that they needed, and if they needed help in the future, they would 

return to Triple P. 

� Parents participating in the Level 2 Seminars and Level 3 Workshops filled out a short 

Satisfaction Survey with 3 questions using a 5‐point scale (with 1=Disagree, and 5=Agree), 

and 1 open‐ended question. 

o The average parent satisfaction ratings for Level 3 Workshops ranged from 4.76 to 4.84, 

and Level 2 Seminars ranged from 4.47 to 4.71, on the 5‐point scale. Virtually all parents 

felt that the program answered their questions, that they would continue to use the tip 

sheets, and were very satisfied with the services they received. 

Figure 99: Parents’ Satisfaction with Various Aspects of the Triple P Program 

Levels 3 (multi‐session), 4, and 5 

1. How would you rate the quality of the service you and your child 


2. Did you receive the type of help you wanted from the program? 

(N=98) 

3. To what extent has the program met your child's needs? (N=99) 


5. How satisfied were you with the amount of help you and your 


6. Has the program helped you to deal more effectively with your 

child's behavior? (N=99) 





9. In an overall sense, how satisfied are you with the program you 

and your child received? (N=98) 



11. Has the program helped you to develop skills that can be applied 

to other family members? (N=98) 

12. In your opinion, how is your child's behavior at this point? (N=97) 

13. How would you describe your feelings at this point about your 

child's progress? (N=97) 

Source: Triple P data from the Parent Satisfaction Survey, collected and analyzed by Applied Survey Research, 2011. 


5.73 

5.62 

6.13 

6.03 

137 

6.48 

6.37 

6.49 

6.51 

6.40 

6.29 

1 2 3 4 5 6 7 

6.58 

6.71 

6.58



1. The workshop answered a question or concern I have had 

about parenting. (N=76) 


sheet. (N=76) 


Level 3 Workshops 

Source: Triple P data from the Workshop Satisfaction Survey, collected and analyzed by Applied Survey Research, 2011. 


1. The seminar answered a question or concern I have had about 

parenting. 


sheet. 

3. Overall I was satisfied with the seminar 

1 2 3 4 5 

Level 2 Seminars 

Source: Triple P data from the Seminar Satisfaction Survey, collected and analyzed by Applied Survey Research, 2011. 


N=17. 


4.53 

4.47 

4.76 

4.82 

4.84 

4.71 

1 2 3 4 5


Mountain Community Resources 



STRONG FAMILIES – MOUNTAIN COMMUNITY RESOURCES 

In order to promote child and parent confidence and competence, reduce child maltreatment, 

destigmatize parenting information and family support, and provide evidence‐based parenting 

information to the San Lorenzo Valley and Scotts Valley communities, Mountain Community 

Resources facilitated 13 Triple P workshops (seven in English and six in Spanish) in 2010‐11. This 

agency also conducted a series of four‐week, individual sessions with five adults, benefiting a total 

of seven children. 



Participated in Triple P (unduplicated) 



Source: Mountain Community Resources, 2010‐11. 

(ages 6‐17) 48 


7.5% 

Source: Mountain Community Resources, 2010‐11. 

N=67. 

92.5% 

One client’s story: 

“One of [our practitioners] worked with a single mother, Candy,* who has a 4-year old son. She came to the center 

looking for help with her son, Jim*, because she was having problems with him. Candy had heard about Triple P but 

was not sure about taking parenting classes. … She agreed to attend the required visits and they met for a total of four 

meetings. … 

At the last meeting Candy decided to bring Jim to the appointment. Jim came walking rather quickly into the 

[practitioner’s] office and proceeded to give her a picture that he had drawn and hugged her legs with great force. He 

then looked at mom and said, “what was it I wanted to say?” Mom said, “I remember you wanted to say thank…” 

and then Jim jumped up and down and said “thank you thank you, mom doesn’t yell so much anymore and I like quiet 

time… a boy needs quiet times and so does mom sometimes.” He then asked to play with the toys outside of her office. 

Both mom and child had smiles that ran from ear to ear.” 

- Mountain Community Resources, Annual Progress Report 



Level 3 (Primary Care/Individual) 

139


STRONG FAMILIES – MOUNTAIN COMMUNITY RESOURCES 

Parents Reported High Satisfaction with Services 

All parents receiving Triple P services were asked to complete a self‐administered satisfaction survey 

upon completing their services. Parents participating in the Level 3 Workshops filled out a short 

Satisfaction Survey with 3 questions using a 5‐point scale (with 1=Disagree, and 5=Agree), and 1 

open‐ended question. 

� The average parent satisfaction ratings for Level 3 Workshops ranged from 4.49 to 4.72, on 

the 5‐point scale. Virtually all parents felt that the program answered their questions, that 

they would continue to use the tip sheets, and were very satisfied with the services they 

received. 

1. The workshop answered a question or concern I have had 

about parenting. (N=95) 


sheet. (N=94) 


Level 3 Workshops 

Source: Triple P data from the Workshop Satisfaction Survey, collected and analyzed by Applied Survey Research, 2011. 

Note: All items were on a 5‐point scale. Higher scores indicate greater satisfaction. Satisfaction Survey results for parents participating in Levels 3 

(multi‐session), 4, and 5 of the Triple P Program will be available when there are higher client numbers. 


4.49 

4.72 

4.65 

1 2 3 4 5


Early Literacy Foundations (ELF) 



CHILDREN LEARNING AND READY FOR SCHOOL ‐ EARLY LITERACY FOUNDATIONS 

California third graders are struggling to become proficient readers. Local and statewide data 

indicate that well over half of third grade children are not reading at proficiency. Because language 

development in the early years is crucial to later reading success, early childhood educators have a 

unique role in influencing reading scores and later educational success. According to a report 

published in the Journal of Education Psychology, early childhood educators play a key role in the 

language development of children from high poverty backgrounds: 

“Language development has a profound effect on young children’s successful transition to 

school and, in particular, on their success in learning to read. Children who arrive in first grade 

with a foundation in pre‐literacy skills and the interest and motivation to learn are better 

prepared to engage in the complex task of learning to read. 

Most children acquire language and pre‐literacy skills through interactions with adults and 

peers who use language in ways that are consistent with the majority culture and correspond 

to the printed word. Unfortunately, many children raised in poverty have limited access to 

opportunities to develop language and literacy skills in such ways. 

As one important illustration, Hart and Risley (1995) reported that by the age of 3, children in 

poverty were already well behind their more affluent peers in their acquisition of vocabulary and 

oral language skills. Snow et al. (1998) also reported that children in poverty lack necessary 

pre‐literacy skills at the beginning of kindergarten. Similar research indicates that socioeconomic 

status is the strongest predictor of performance differences in children at the beginning of the 

first grade and that this gap persists as children progress from elementary to high school.” 25 

With the evidence of limited language and literacy opportunities in low‐income homes, more 

emphasis has been placed on showing early childhood educators how to build language 

opportunities into their daily child care routines, through fun and meaningful instruction. First 5’s 

Early Literacy Foundations Initiative builds skills among early childhood educators to promote strong 

literacy and language foundations for young children. The Initiative features: 

1. Professional development for early childhood educators through unit‐bearing coursework in 

partnership with Cabrillo College. Through the SEEDS of Early Literacy courses, educators 

earn three units and a stipend, receive on‐site coaching, attend literacy labs, and complete a 

professional development plan. Classes are available for early childhood educators who care 

for preschool children and infant/toddlers. Three different courses have been developed in 

both English and Spanish to meet the unique needs of educators new to college coursework 

as well as teachers with formal educational experience. 

25 

American Psychological Association (2006). The Effects of a Language and Literacy Intervention on Head Start Children and Teachers. 

Journal of Educational Psychology, 98, (1), 63–74. 

141



2. Assessment of children’s development of early literacy skills via the Individual Growth and 

Development Indicators (IGDI’s), and coaching for teachers to support response to 

intervention and differentiated instruction in participating State Pre‐K classrooms. 

3. Skill and materials development with Family, Friend and Neighbor informal providers 

through SEEDS early literacy workshops and coaching. 

4. Family Engagement through an expansion of “Raising A Reader,” a rotating book bag 

program. Almost all of the SEEDS classrooms were also Raising A Reader classrooms, 

resulting in mutually complimentary interventions to boost shared reading practices with 

children and their families, and to impact children’s early literacy skills. Information on this 

program can be found in the Raising A Reader partner profile. 

5. The Santa Cruz Public Libraries (SCPL) “Read to Me” program provides Read to Me Resource 

Kits for parents and early childhood educators via library circulation to engage children and 

families in early literacy activities. 

SEEDS of Early Literacy 

The professional development initiative described above (1) follows the SEEDS of Early Literacy 

curriculum that has been researched by the University of Minnesota. Research on the SEEDS model 

shows that teachers trained and coached on the SEEDS Curriculum score significantly higher on the 

Early Language and Literacy Classroom Observation (ELLCO) tool and show greater change over time 

in teaching strategies than teachers without such training. Results also indicate that preschool 

children who were taught by teachers trained in 

SEEDS entered kindergarten ready to read at higher 

rates than children in non‐SEEDS groups (Lizakowski, 

2005). 

“I started this course with the idea that early literacy 

was teaching children to write letters, help them form 

words, and read. Now I know that early literacy is not 

only symbols. It is the combination of strategies that will 

help the child in a playful way to build strong 

foundations in learning.” 

The SEEDS Professional Development model consists 

of training—and providing coaching to—early 

childhood educators on how to effectively integrate 

research‐based language and literacy strategies and 

materials into their classrooms. Early childhood 

educators are taught to use the strategies of both embedded instruction (planned strategies that 

occur within the typical routines of the class day) and explicit instruction (teacher‐directed activities 

that emphasize the teaching of a specific task), and to create a classroom environment that is 

designed to target early literacy predictors. 

These predictors of later reading success include: 

- Early childhood educator who just started the SEEDS program 

Early Literacy Foundations, Annual Progress Report 

� Conversation and Oral Language: The ability to produce or comprehend spoken language 

� Alphabet Knowledge: The ability to visually discriminate the differences between letters 

and say the names and sounds associated with printed letters 





� Book and Print Rules: Refers to what children understand about how books and print work, 

such as left‐right, front‐back, letters, words and that print has meaning 

� Phonological awareness: The ability to detect, manipulate, or analyze the auditory aspects 

of spoken language, including the ability to distinguish or segment words, syllables, rhymes, 

and beginning sounds 

� Vocabulary and Background Knowledge: A collection of words that relate to experiences 

and knowledge that a child has of the world around him/her 

The following diagram displays the five essential SEEDS quality interactions and the five predictors of 

literacy. 

Santa Cruz County’s SEEDS program has proven to be very effective at changing classroom 

environments and practices, as well as influencing changes in children’s skills on research‐based 

predictors of early reading. 


Number of new or returning SEEDS Quality Coaches providing literacy coaching, literacy 

environmental assessments, and professional development advising for SEEDS instruction, 

fidelity and integrity 


Number of early childhood educators attending SEEDS of Early Literacy Courses 77 

Number of Family, Friend or Neighbor (FFN) informal child care providers attending SEEDS of 

Early Literacy workshops 

TOTAL (unduplicated) 104 


143 

18 

9



The figures below show additional data about Early Childhood Educators and Coaches who have 

been trained between 2007‐2011. 

Figure 101: Number of Early Childhood Educators Who Have Completed SEEDS 

trainings (2007-2011) 

Number of SEEDS Quality Coaches providing literacy coaching, literacy environmental 

assessments, and professional development advising for SEEDS instruction, fidelity, and 

integrity during the year 

CUMULATIVE TOTALS 

2007‐2011 

Number of early childhood educators attending SEEDS of Early Literacy Courses 356 

Number of Family, Friend or Neighbor (FFN) informal child care providers attending SEEDS 

of Early Literacy workshops 

TOTAL (unduplicated) 519 

Source: Early Literacy Foundations (ELF) Initiative, 2010‐11. 

Figure 102: Number of SEEDS Trained Early Childhood Educators in Licensed 

Programs, by type of classroom (2007-2011) 

State and Federally‐ 

Subsidized Classrooms 

Source: Early Literacy Foundations (ELF) Initiative, 2007‐11. 

Figure 103: Primary Language of SEEDS Trained Early Childhood Educators in Licensed 

Programs (2007-2011) 

22.2% 

3.1% 

24.7% 

Licensed Family Child Care 

Homes and Private/ Non‐ 

Profit Centers 

English Only 

Spanish Only 

Bilingual English/Spanish 

50.0% 







Other 

41 

155 

Unduplicated total, 

Spring 2007 – June 2011 

201 155 356




Figure 104: Educational Attainment of SEEDS Trained Early Childhood Educators in 

Licensed Programs (2007-2011) 

12.2% 

6.1% 






Outcome Objective: Increase the number of early education settings that provide 

high quality support for language and literacy 

Preschool Classrooms 

4.0% 4.3% 8.8% 

No Formal Schooling 

7.3% 

10.1% 

Less Than High School Diploma/GED 

25.3% 

22.0% 

High School Diploma/GED 

Some College 

AA in non‐ECE/CD 

AA in ECE/CD 

BA in non‐ECE/CD 

BA in ECE/CD 

Some Graduate School or above 

Research on teacher effectiveness shows that by focusing professional development on language 

and literacy and social‐emotional development, children are shown to be much better prepared for 

school and have higher academic achievement. The first indicators of change are the language 

environment, teacher‐child interactions, and language opportunities that teachers provide to 

children. 

First 5 SEEDS Quality coaches are trained to independently assess SEEDS classrooms teaching 

children ages 3‐5 using the Early Language and Literacy Classroom Observation Pre‐K Tool (ELLCO 

Pre‐K). The ELLCO Pre‐K is used to assess the following five classroom components: classroom 

structure, curriculum, the language environment, books and book reading, and print and early 

writing (in 2010‐11, the classroom structure component was not measured by most coaches and is 

therefore not analyzed in this report). Items are scored along a 5 point scale, where 1 is deficient 

and 5 is exemplary. From this scale, early childhood educators’ classroom scores can be categorized 

into three levels, indicating their classroom environment provides low‐quality support, basic 

support, or high‐quality support for language and literacy. In every Pre‐K SEEDS course since 2007, 

coaches used the ELLCO to assess the classrooms of their mentees (early childhood educators 

receiving SEEDS training) at the beginning and end of the semester. 

Across all components, classrooms showed substantial improvements from the beginning of the 

semester to the end. Overall, the percentage of classrooms that were rated as having High‐Quality 

Support increased from 16% to 92%. Among the individual classroom components, by the end of the 

145



semester the majority of classrooms were rated as having High‐Quality Support in “Curriculum” 

(81%), “Language Environment” (76%), “Books and Book Reading” (87%), “Print and Early Writing” 

(89%). 

Figure 105: Classroom Support for Language and Literacy, 2010-2011 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

16.2% 

54.1% 

91.9% 


18.9% 

51.4% 

81.1% 

Source: Early Literacy Foundations Initiative, Early Language and Literacy Classroom Observation (ELLCO) Pre‐K, 2010 – 2011. 

Note: Low‐quality support = means less than or equal to 2.5; Basic support = means between 2.51 and 3.5; High‐quality support = means between 

3.51 and 5. Percentages less than 3% are not labeled. 

N=37. 

Four specific ELLCO items were chosen for individual study, using the same type of analysis: 

Opportunities for Child Choice and Initiative, Approaches to Book Reading, Support for Children's 

Writing, and Approaches to Curriculum. For these four items, several years of data have been 

aggregated in order to present a more robust portrait of the extent to which SEEDS‐trained early 

childhood educators were providing high quality support for language and literacy in their preschool 

classrooms. 

16.2% 

51.4% 

75.7% 

13.5% 

56.8% 

86.5% 

29.7% 29.7% 32.4% 29.7% 

24.3% 

18.9% 

13.5% 

8.1% 

21.6% 

35.1% 

43.2% 

As reflected in the following figure, SEEDS‐coached teachers have consistently improved the quality 

of support they provide in their classrooms for children’s development of early literacy. For each of 

the four ELLCO items, the majority of classrooms were rated as providing high quality support at 

post assessment: Opportunities for Child Choice and Initiative (93%), Approaches to Book Reading 

(88%), Support for Children's Writing (90%), and Approaches to Curriculum (87%). 


89.2% 

Pre Post Pre Post Pre Post Pre Post Pre Post 

Overall Section 2: 

Curriculum 

Section 3: 

The Language 

Environment 

Section 4: 

Books & Book 

Reading 

8.1% 

Section 5: 

Print & Early 

Writing


Figure 106: Key Language and Literacy Questions (2007-2011) 

100% 

53.7% 

35.8% 


93.3% 

35.3% 

49.3% 

88.4% 


10.4% 15.3% 19.5% 22.4% 

6.7% 

10.7% 

10.0% 

Source: Early Literacy Foundations Initiative, Early Language and Literacy Classroom Observation (ELLCO) & ELLCO Pre‐K, 2007 – 2011. 

Note: Clients may be included more than once if they participated in multiple SEEDS classes between 2007 and 2011. Low‐quality support = means 

less than or equal to 2.5; Basic support = means between 2.51 and 3.5; High‐quality support = means between 3.51 and 5. Percentages less than 3% 

are not labeled. 

* The analysis of the question began in 2007‐08, so results reflect the combined data for 2008‐2011. 

Child Choice and Initiative N=134, Book Reading N=215, Children's Writing N=221, Approaches to Curriculum N=134. 

Family Child Care Settings 

The data above described the ways that SEEDS‐trained teachers made changes to their preschool 

classroom environments and their practices in order to better support children’s development of 

pre‐literacy skills. However, SEEDS training was not just limited to preschool center teachers — early 

childhood educators from family child care settings as well as infant/toddler centers also 

participated in SEEDS training and received SEEDS coaching. Their sites were observed at the 

beginning of their SEEDS training and again at the end. 

31.2% 

49.3% 

89.6% 

The figure below presents the PRE and POST scores gathered from Family Child Care providers on 

four literacy‐related indicators, for several years combined. The measurement instrument was the 

Family Child Care Environment Rating Scale, Revised Edition (FCCERS‐R). Items were scored using a 

7‐point scale ranging from inadequate to excellent. Results show that providers made pre to post 

gains in their abilities related to literacy promotion. 

Figure 107: Average FCCERS Scores at Pre and Post Assessment on Literacy-Related 


Pre Post 

Excellent 

7 

80% 

60% 

40% 

20% 

0% 

6 

5 

4 

3 

2 

1 

0 

Inadequate 


Source: Early Literacy Foundations (ELF) Initiative, Family Child Care Environment Rating Scale, Revised Edition, 2009‐2011. 

N=54. 

40.3% 

37.3% 

86.6% 

12.7% 

Pre Post Pre Post Pre Post Pre Post 

Opportunities for 

Child Choice and 

Initiative* 

Approaches to 

Book Reading 

3.83 3.93 3.94 



Support for 

Children's Writing 

5.46 5.44 5.65 5.80 


language 

4.24 

Using books Provider‐child 

interactions 

Approaches to 

Curriculum* 

147



Infant/ Toddler Care Classrooms 

The figure below presents the PRE and POST scores gathered from center‐based early childhood 

educators of Infant/Toddler care, for several years combined. The measurement instrument was the 

Infant/Toddler Environment Rating Scale, Revised Edition (ITERS‐R), and items were scored using a 7‐ 

point scale ranging from inadequate to excellent. Results show that Infant/ Toddler teachers 

enhanced their classroom environments and practices to promote children’s early literacy 

development. 

Figure 108: Average ITERS Scores at Pre and Post Assessment on Literacy-Related 


Excellent 

Pre Post 

7 

6.02 6.14 5.76 5.92 

6 

5 

4 

3 

2 

1 

0 

Inadequate 

4.39 



4.82 


language 

Source: Early Literacy Foundations (ELF) Initiative, Infant/Toddler Environment Rating Scale, Revised Edition (ITERS‐R), 2009‐2011. 

N: Understand language=49, Use language=49, Using books=49, Interactions=48. 

Other Outcomes: Children will increase their skills in research-based predictors 

for reading success 

The SEEDS of Early Literacy has shown us that teachers of diverse educational backgrounds can be 

trained to implement strategies to help children build a strong language and literacy foundation. 

First 5 partnered with SEEDS state subsidized classrooms and found that, indeed, teachers have had 

a positive effect on children’s language and literacy development. 

Participating classrooms assessed children throughout the year to measure changes in three key 

areas of reading predictors: picture‐naming, rhyming, and alliteration. As the majority of students 

are dual language learners, most children were assessed in both English and Spanish, unless English 

was their primary language. 

Children showed large improvements in all three pre‐literacy skills areas between their first and last 

assessments. The percentage of all children scoring “At” or “Above” the target level for each of the 

pre‐literacy skills areas increased dramatically, with the greatest improvement occurring in rhyming 

and alliteration skills. 


3.78 

4.60 

Using books Provider‐child interactions




Figure 109: Percentage of All Children Scoring “At” or “Above” the Target Level 

in Three Pre-Literacy Skill Areas, 2010-2011 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

12.4% 

27.3% 

34.1% 

English Assessment Spanish Assessment 

30.7% 

9.3% 

49.7% 


51.1% 

63.1% 


English N= Oct: Picture Naming (340); Rhyming (332); Alliteration (328). N= Jan: Picture Naming (275); Rhyming (264); Alliteration (262). N= May: 

Picture Naming (337); Rhyming (332); Alliteration (325). Spanish N= Oct: Picture Naming (231); Rhyming (228); Alliteration (228). N= Jan: Picture 

Naming (209); Rhyming (206); Alliteration (211). N= May: Picture Naming (237); Rhyming (234); Alliteration (230). 

Note: Children who completed any two assessments within a pre‐literacy skill area were included in the analysis of that skill. 

Because of the number of English‐language learners in these classrooms (who comprised 

approximately 73% of children in this assessment), there was interest in focusing on the 

performance of children when assessed in their primary language. When looking at the percentage 

of children scoring “At” or “Above” target level, results show that when assessed in their primary 

language, Spanish‐speaking children started with a lower skill level than English‐speaking children, 

but by their last assessment they had made a greater amount of improvement (net change in 

percentage) in rhyming (39% increase vs. 30% increase), and in alliteration (53% increase vs. 46% 

increase). Primarily Spanish‐speaking children showed similar or even greater amounts of 

improvement when assessed in English, with the greatest increases occurring in rhyming (44% 

increase) and alliteration (54% increase). 

6.1% 

13.4% 

28.3% 

25.7% 

7.5% 

45.3% 

18.4% 

55.5% 

Picture Naming Rhyming Alliteration Picture Naming Rhyming Alliteration 

Oct Jan May 

70.9% 

149



Figure 110: Percentage of Children Scoring “At” or “Above” the Target Level in Three 

Pre-Literacy Skill Areas, by Primary Language, 2010-2011 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

32.3% 

30% 

20% 

10% 

0% 

Figure 111: Percentage of Children Meeting Targets for Later Reading Success, 

by Primary Language 

LANGUAGE OF 

ASSESSMENT 

PRIMARILY ENGLISH‐SPEAKING CHILDREN NET CHANGE 

TOPIC AREA OCT JAN MAY 


LANGUAGE OF 

ASSESSMENT 

Primarily English‐Speaking 

Children 


62.1% 

57.1% 

Picture 

Naming 

31.0% 

18.5% 

56.9% 

48.9% 

21.7% 

68.1% 

13.6% 

6.3% 


Naming 

29.3% 

26.0% 

Rhyming 18.5% 31.0% 48.9% 30.4% 

Alliteration 21.7% 56.9% 68.1% 46.4% 

PRIMARILY SPANISH‐SPEAKING CHILDREN NET CHANGE 

OCT JAN MAY 

Spanish Picture Naming 6.3% 13.6% 29.3% 23.0% 

Rhyming 7.7% 26.0% 46.5% 38.8% 

Alliteration 18.9% 56.0% 72.3% 53.4% 


Rhyming 5.8% 30.6% 50.0% 44.2% 

Alliteration 7.2% 49.8% 61.1% 53.9% 







Note: Table displays the percentage of children scoring “at” or “above” the target level in these three pre‐literacy skill areas. Children who completed 

any two assessments within a pre‐literacy skill area were included in the analysis of that skill. Children were determined to be primarily English 

speakers if they were marked as being “English‐only” speakers on the scoring template, or if they did not take any assessments in Spanish. Children 

were determined to be primarily Spanish speakers if they were not marked as being “English‐only” speakers on the scoring template, and if they took 

at least one assessment in Spanish. The number of children marked as being “English‐only” speakers who also completed an additional assessment in 

Spanish was too low to analyze. 


7.7% 

46.5% 

18.9% 

56.0% 

72.3% 

18.0% 


Naming 

Oct Jan May 


Spanish Assessment English Assessment 

25.6% 

30.6% 

50.0% 

4.9% 5.8% 7.2% 

49.8% 

61.1% 

Rhyming Alliteration




An analysis of the percentage of children who scored at each of the four target levels (Below, Near, 

At, and Above) shows these results in more detail. 

� When examining children in their primary language, English‐speaking children made the 

greatest improvements in Alliteration, followed by Rhyming and Picture Naming. 

� A higher percentage of Spanish‐speaking children scored “below” or “near” target levels in 


assessment, they had reached or exceeded the levels attained by English‐speaking children, 

particularly in rhyming and alliteration, in both languages. 

� Spanish‐speaking children did not make the same achievements in the Picture Naming area 

as they did in the other two areas. 

Figure 112: Percentage of Children at Each Target Level in Three Pre-Literacy Skill 

Areas, by Primary Language, 2010-2011 

100% 

80% 

60% 

40% 

20% 

0% 

100% 

80% 

60% 

40% 

20% 

0% 

30.1% 

2.2% 

46.2% 

21.5% 

55.2% 

6.9% 

31.0% 

53.8% 

3.3% 

31.9% 

6.9% 11.0% 

Primarily English‐Speaking Children 


15.2% 

3.3% 

28.3% 

53.3% 

24.1% 

6.9% 

27.6% 

41.4% 

43.3% 

5.6% 

33.3% 

17.8% 

16.3% 

5.4% 

21.7% 

56.5% 

47.1% 

9.8% 

29.4% 

13.7% 

Oct Jan May Oct Jan May Oct Jan May 

63.5% 

Picture Naming Rhyming Alliteration 

4.5% 

1.8% 9.7% 

3.9% 

30.2% 

54.4% 

32.0% 

22.7% 

6.6% 

41.0% 

29.7% 

Below Near At Above 


Spanish Assessment 

3.2% 

4.5% 

14.4% 

77.9% 

18.6% 

7.4% 

33.8% 

40.2% 

41.2% 

5.3% 

30.3% 

23.2% 

14.4% 

4.5% 

18.9% 

62.2% 

50.7% 

5.3% 

16.3% 

27.8% 

57.1% 


12.1% 

19.8% 

63.4% 

8.9% 

13.4% 




14.3% 

151



100% 

80% 

60% 

40% 

20% 

0% 

3.6% 

1.2% 

19.0% 

76.1% 

16.1% 

1.8% 

25.3% 

56.7% 

22.0% 

3.7% 

32.1% 

42.3% 







Note: Children who completed any two assessments within a pre‐literacy skill area were included in the analysis of that skill. Children were 

determined to be primarily English speakers if they were marked as being “English‐only” speakers on the scoring template, or if they did not take any 

assessments in Spanish. Children were determined to be primarily Spanish speakers if they were not marked as being “English‐only” speakers on the 

scoring template, and if they took at least one assessment in Spanish. The number of children marked as being “English‐only” speakers who also 

completed an additional assessment in Spanish was too low to analyze. 

Santa Cruz Public Libraries – Read to Me 

The Santa Cruz Public Libraries (SCPL) “Read to Me” program provides Read to Me Resource Kits for 

parents and early childhood educators via library circulation to engage children and families in early 

literacy activities. SCPL also provides in‐service workshops on the use of Read to Me kits to the First 5 

SEEDS classes (both English and Spanish), and State Pre‐K programs (Community Bridges). 


Number of Read to Me Kits circulated 1,137 

Number of workshops conducted 30 

Source: Santa Cruz Public Libraries, Annual Progress Report, 2010‐2011. 



4.2% 

1.7% 

20.4% 

14.6% 

41.3% 

10.2% 

79.6% 


36.4% 

33.0% 

8.7% 

27.3% 

22.7% 

5.5% 

1.7% 

19.5% 

73.3% 

41.7% 

8.1% 

19.9% 

30.3% 




“SCPL is most proud that we have not only continued quality early literacy programming in 

extremely stressful and difficult economic times, we have expanded our programming and 

reached out to more families than ever with classes and Read to Me Kits. 

We have begun a collaboration with the County Office of Education that serves families of 

preschool children and rising kindergarteners, and we have continued our partnerships with 

many local agencies.” 

-Santa Cruz Public Libraries, Annual Progress Report 

55.6% 

5.6% 

17.1% 

21.8%


Raising A Reader 



CHILDREN LEARNING AND READY FOR SCHOOL ‐ RAISING A READER 

Raising A Reader (RAR) fosters healthy brain development, helps support parent‐child bonding, and 

motivates families to read aloud with their children which helps develop the early literacy skills that 

are critical for school success. Raising A Reader (RAR) began operation in Watsonville during the last 

quarter of the 2005‐06 funding cycle. The program provides a way for children and their parents or 

caregivers to participate in a weekly rotating book bag program through early care and education 

settings. Periodically, Raising A Reader visits participating sites to monitor how well the program is 

operating, and provide refresher books or trainings as needed. 



New Existing Total 

Children 2,564 2,830 5,394 


One provider’s story: 

“Parents were skeptical at first about reading to their child at such a young age. But I shared the 

benefits of introducing reading at this very tender age. There's early language development, 

interest in reading at an earlier age, they do better in school, etc…, and as time went by, parents 

shared that their child was actually taking an interest and found it a place in their daily routine 

with their child.” 

-Raising A Reader, Annual Progress Report 

Outcome Objective: Raising A Reader will support 210 sites 

Type of Early Educator 2010‐2011 

Family Child Care Home 133 

Preschool/Child Care Center 106 

Source: Raising A Reader/First 5 Santa Cruz County, 2010‐2011. 

Note: The actual number of classrooms participating in Raising A Reader is likely to be higher than the total number of sites, as one site may include 

more than one classroom. 

153


CHILDREN LEARNING AND READY FOR SCHOOL ‐ RAISING A READER 

Outcome Objective: Parents will spend time reading or sharing books with their 

child 

Percentage of parents who report reading 3 or more times per week after 

participating in the RAR book bag program. 

Source: Raising A Reader Parent Survey, 2010‐2011. 


PRE‐TEST POST‐TEST 

49.3% 


N=454 

Figure 113: Changes in How Frequently Parents Read With Their Child, 2010-2011 

100% 

80% 

60% 

40% 

20% 

0% 

17.4% 

31.9% 

34.6% 

16.1% 

15.1% 

0.4% 

Pre‐Test Post‐Test 

Source: Raising A Reader/First 5 Santa Cruz County, 2010‐2011. 

N: Pre‐Test=454, Post‐Test=456. 

37.1% 

47.4% 

5+ times/week 

3‐4 times/week 

1‐2 times/week 

Rarely 

84.4% 

N=456


Starlight Infant/Toddler Program 



CHILDREN LEARNING AND READY FOR SCHOOL ‐ STARLIGHT INFANT/TODDLER PROGRAM 

The Starlight Infant/Toddler Program (SITP) is a collaboration between Santa Cruz Community 

Counseling Center’s Early Head Start and First 5 of Santa Cruz County. This innovative program 

offers a wide variety of comprehensive bilingual services for expectant parents and families with 

infants and toddlers in the Watsonville area of 

south Santa Cruz County. A key goal is to create a 

“learning community” that promotes early 

literacy and social emotional skills to help lay a 

solid foundation for school readiness. 

Services include pre‐ and post‐natal support to 

ensure healthy outcomes, assessments on health, 

nutrition, and developmental areas, ongoing 

parent education workshops, individualized home 

visits and goal‐setting, infant and toddler play 

groups, and referrals to community resources. 


“The Starlight Infant/Toddler program has 

significantly impacted the lives of local families and 

very young children by providing positive early 

learning experiences, opportunities for growth, and 

access to comprehensive health and social services. The 

program follows high-quality best practice standards 

and research-based strategies with a replicable model 

for intervention with high-risk low-income families 

from pregnancy and birth up through age three. SITP 

offers additional support during the crucial early years 

to minimize disparities and ensure strong families and 

healthy children who are ready to learn.” 


Pregnant Women 12 


Children 54 


- Starlight Infant/Toddler Program, Annual Progress Report 

Outcome Objective: Pregnant women will keep medical appointments 

75% of pregnant women will keep all prenatal appointments and will keep all 

postpartum follow‐up visits and first newborn doctor visits. 

Source: Starlight Infant/Toddler Program, Early Head Start home based Desired Results Parent Survey, Spring 2011. 



88.9% 

Outcome Objective: Pregnant women will make positive lifestyle changes 

60% of pregnant women will make a positive lifestyle change such as decreased 

caffeine intake, smoking cessation, increased exercise, and increase information 

regarding health and wellness. 

Source: Starlight Infant/Toddler Program, Early Head Start home based Desired Results Parent Survey, Spring 2011. 


N=9 


100% 

N=9 

155



Outcome Objective: Children’s development will be assessed using the DRDP-I/T 

By June 30, 2011, 40 children ages 0‐3 will be assessed using the Desired Results Developmental 

Profile for Infants and Toddlers (DRDP‐I/T) (indicators 6, 7, 15, 16, 17, 18, 28 and 29), with a 

baseline assessment completed in February and the second assessment completed in June. 

Supports for families in specific areas of language and literacy will be tailored based on the 

initial assessment and a comparison will be made to see if there have been gains. 

Source: Starlight Infant/Toddler Program, Desired Results Developmental Profile I/T (2010), 2010‐2011 


55 children 

In their first 3 years of life, children’s neural pathways are being developed and cemented as a 

foundation for a life full of learning. Quality early childhood experiences help to foster better 

language skills, higher cognitive functions, as well as improving sensory pathways, according to the 

Harvard University Center on the Developing Child. Therefore, literacy promotion doesn’t begin in 

preschool – it starts much earlier, even in daily interactions with young babies. 

At the Starlight Infant/Toddler program, home visitors work with parents of infants and toddlers to 

build the foundations for literacy. To guide their efforts with children and their families, they assess 

children periodically using eight indicators of the DRDP – Infant Toddler (2010). 

DOMAIN ITEM 

Social‐interpersonal skills 

Language 

Literacy 

(scale of 1‐5) 



Interactions with adults 

Relationships with familiar adults 

Language comprehension 

Responsiveness to language 

Communication of needs, feelings, and interest 

Reciprocal communication 

Interest in literacy 

Recognition of symbols 

Assessment results show that infants and toddlers in the Starlight Infant/Toddler program are being 

supported to develop social and interpersonal skills, and to develop a strong foundation for later 

literacy. As seen in the following figures: 

� The majority of infants increased one or more developmental levels in all measures, with the 

greatest increases occurring in the measures of “Reciprocal communication” (94% of children 

increased one or more levels), “Responsiveness to language” (72%), and “Interest in literacy” 

(72%). 

� Toddlers also made increases in one or more developmental levels in all measures, with the 

greatest increases occurring in the measures of “Communication of needs, feelings, and 

interest” (70% of children increased one or more levels), and “Reciprocal communication” 

(70%). 





Figure 114: Percentage of Children Who Made Developmental Changes in Key Social 

and Pre-Literacy Measures 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

100% 

90% 

80% 

70% 

60% 

50% 

40% 

30% 

20% 

10% 

0% 

11.8% 11.8% 11.1% 

52.9% 52.9% 50.0% 

29.4% 

35.3% 

27.8% 

Infants (0 – 17 months) 

16.7% 

55.6% 

27.8% 

52.9% 

41.2% 

83.3% 

5.9% 11.1% 

5.6% 5.6% 

30.0% 

45.0% 

26.3% 

52.6% 

5.0% 5.3% 

35.0% 

30.0% 

Toddlers (18 – 36 months) 

40.0% 

25.0% 

44.4% 

22.2% 

44.4% 

27.8% 


Source: Starlight Infant/Toddler Program, Desired Results Developmental Profile I/T (2010), 2010‐2011 

* Only these four questions with 6 developmental levels have the ability to increase 5 levels. 

Notes: Only children who completed at least the first and third assessments have been included. This analysis excludes children who already scored at 

the highest developmental level on the 1st assessment. Ages are calculated as of the date of the 3rd assessment. “All Children” calculations include 

infants, toddlers, and children older than toddlers. 

Infant N: Interactions with Adults=17, Relationships with Familiar Adults=17, Language Comprehension=18, Responsiveness to Language=18, 

Communication of Needs, Feelings, and Interest=17, Reciprocal Communication=18, Interest in Literacy=18, Recognition of Symbols=18. 

Toddler N: Interactions with Adults=20, Relationships with Familiar Adults=19, Language Comprehension=20, Responsiveness to Language=20, 

Communication of Needs, Feelings, and Interest=20, Reciprocal Communication=20, Interest in Literacy=19, Recognition of Symbols=20. 

5.9% 

50.0% 


5.3% 5.0% 

5.0% 

20.0% 10.5% 15.0% 

20.0% 20.0% 10.0% 

55.0% 

15.0% 15.0% 

27.8% 

10.5% 

42.1% 

16.7% 

5.0% 

50.0% 

36.8% 35.0% 

15.0% 15.0% 15.0% 15.0% 10.5% 10.0% 

Increased 2 Levels 

Increased 1 Level 

No Change in Levels 

Decreased in Levels 




Increased 1 Level 

No Change in Levels 

Decreased in Levels 

157


CHILDREN LEARNING AND READY FOR SCHOOL ‐ CHILD SNAPSHOT 

School Readiness � Steps to Success 

Child Snapshot 


First 5 Santa Cruz County has continued working with kindergarten, preschool, and family child care 

teachers to communicate about children who are transitioning to school. The vehicle for this 

communication is the Child Snapshot form. The form was developed in partnership between 

kindergarten teachers and early childhood educators as an easy and effective way to support 

children’s transition to kindergarten. The Snapshot is a three‐page form completed by both the 

parent and the preschool teacher in the spring prior to kindergarten, and it includes brief 

information about the child’s interests and abilities, language and developmental concerns, 

preschool experience and developmental information. They are collected and delivered by First 5 

staff to the schools the children will be attending, and then routed to each child’s new kindergarten 

teacher. As such, the form provides kindergarten teachers with family and preschool information 

about their new students, and helps them become more familiar with the preschool and child care 

programs which feed into their elementary schools. 

Each year, the Transition to Kindergarten Advisory group receives feedback from kindergarten 

teachers that the Child Snapshot form is an easy and effective way to support a child’s transition to 

kindergarten. 

Over the last few years the form has been expanded to include additional information such as family 

activities and community supports for parents. A measurement of kindergarten readiness was also 

included at the end of the Child Snapshot, using either the Desired Results Developmental Profile ‐ 

Revised, Preschool (DRDP‐PS) or the Pre‐Kindergarten Observation Form, depending upon the type 

of preschool that children attended. For the purposes of this project, scores on the DRDP‐PS were 

“crosswalked” with the P‐KOF in order to have a common frame of measurement by which to 

examine children’s readiness. 



Children 976 


Program Development 

The number of children with Child Snapshots completed on their behalf continues to grow, and 

illustrates the increased communication between early childhood and elementary school settings, 

and the achievements being made to bridge children’s transition to kindergarten. 





� In Spring 2011, a total of 976 preschool children were assessed—509 boys (52%) and 467 

girls (48%). These children were drawn from 42 preschool programs throughout Santa Cruz 

County and their child snapshot forms were shared with kindergarten teachers at 42 

elementary schools in Santa Cruz County and surrounding areas. 

Figure 115: Number of Child Snapshot Forms Collected from Participating Preschool 

Programs 

Source: Applied Survey Research, Child Snapshot Log, 2006‐2010, and Portrait of School Readiness 2011: Transition to Kindergarten—Child Snapshot. 

Pre‐Kindergarten Observation Form and cross‐walked DRDP‐PS, Spring 2011. 

Child Snapshot Results 

The P‐KOF assesses children across 24 readiness skills. These readiness skills can be reliably sorted 

into four domains, or Basic Building Blocks of Readiness: 1) Self‐Care & Motor Skills, 2) Self‐ 

Regulation Skills, 3) Social Expression Skills, 4) Kindergarten Academics. The figure below displays 

children’s overall mean readiness scores as well as their average scores on each of the four Basic 

Building Blocks. 

Proficient 

In Progress 

Beginning 

1,000 

800 

600 

400 

200 

0 

393 

889 

617 

2006‐07 2007‐08 2008‐09 2009‐2010 2010‐11 

Figure 116: Students’ Average School Readiness Levels Across the Basic Building 

Blocks of Readiness 

4 

3 

2 

Not Yet 

1 

3.54 

3.75 

Overall Readiness Self‐Care & Motor 

Skills 


and crosswalked DRDP‐PS, Spring 2011. 

N=900‐904. 

832 

976 

3.50 3.59 3.44 

Self‐Regulation 

Skills 

Social Expression 

Skills 

Kindergarten 

Academics 

159



The next two figures highlight the readiness skills for which students were rated as demonstrating 

the most proficiency and the greatest challenges. Readiness skill strengths were identified within 

the Self Care & Motor Skills, Social Expression, and Kindergarten Academics Basic Building Blocks. 

Figure 117: Students’ Top Five Readiness Strengths 

TOP FIVE STRENGTHS BASIC BUILDING BLOCK 

STUDENTS’ AVERAGE SCORE 

(OUT OF 4.00 POSSIBLE) 

1. General coordination on the playground Self‐Care & Motor Skills 3.84 

2. Uses small manipulatives Self‐Care & Motor Skills 3.76 

3. Recognizes basic colors Kindergarten Academics 3.75 

4. Relates appropriately to adults other than 

parent/primary caregiver 

5. Appropriately expresses needs and wants 

verbally in primary language 

Social Expression 3.65 

Social Expression 3.64 

Source: Applied Survey Research, Portrait of School Readiness 2011: Transition to Kindergarten—Child Snapshot. Pre‐Kindergarten. Pre‐Kindergarten 

Observation Form and cross‐walked DRDP‐PS, Spring 2011. 



Students were still developing the Kindergarten Academic skills involved in recognizing all letters of 

the alphabet and recognizing rhyming words, as well as the Self Regulation Skills involved in 

navigating peer relationships. 

Figure 118: Students’ Top Five Readiness Challenges 

TOP FIVE CHALLENGES BASIC BUILDING BLOCK 

STUDENTS’ AVERAGE SCORE 

(OUT OF 4.00 POSSIBLE) 

1. Recognizes letters of the alphabet Kindergarten Academics 3.05 

2. Recognizes rhyming words Kindergarten Academics 3.29 

3. Handles frustration well Self‐Regulation 3.38 

4. Negotiates with peers to resolve social 

conflict 

Self‐Regulation 3.39 

5. Participates successfully in circle time Self‐Regulation 3.47 


and cross‐walked DRDP‐PS, Spring 2011. 





Literacy Continuing Education Workshops 



CHILDREN LEARNING AND READY FOR SCHOOL ‐ LITERACY CONTINUING EDUCATION WORKSHOPS 

As continuing education support for graduates of the SEEDS of Early Literacy classes, early childhood 

educators receive professional development and make activities and materials that will enhance 

their work environment and promote literacy with young children. Early Literacy Foundation (ELF) 

coaches conduct the trainings. 

Eight workshops were provided, each with a different focus: 

Fall, 2010 

� The first workshop focused on how to use a non‐fiction book with the Repeated Read Aloud 

strategy through the making of various sorting, vocabulary, and matching games. 

� The second workshop focused on vocabulary development through the making of vocabulary 

cards. 

� The third workshop supported phonological awareness through the use of poems, fingerplay 

cards, and rhyming games. 

� The fourth workshop focused on conversation skills through the making of a flannel board 

story and puppets. 

Spring, 2011 

� The first workshop supported book and print rules through creating a Big Book Song book 

and flannel board story. 

� The second workshop emphasized social‐emotional development and vocabulary through 

the use of emotion cards and feeling words. 

� The third workshop focused on book and print rules 

through writing and counting activities. 

� The fourth workshop focused on a non‐fiction book 

using the Repeated Read Aloud strategy through the 

making of matching and sorting games. 


Fall 2010 Spring 2011 

“These workshops encourage children 

to learn letters, words, phonological 

awareness. Thank you for your help in 

making us better educators.” 

-Workshop Participant, 

Spring 2011 Workshop Survey 


Total 

(Unduplicated) 

Early Childhood Educators 23 19 35 

Source: (Fall) Literacy Continuing Education Workshops program data; (Spring) SUN database/CCD data for July 1, 2010 – June 30, 2011. 

161


CHILDREN LEARNING AND READY FOR SCHOOL ‐ LITERACY CONTINUING EDUCATION WORKSHOPS 

Participants filled out an evaluation survey after the series of four workshops, to get their feedback 

on the usefulness of the workshops, and how frequently they used the materials and activities in 

their classrooms. For each survey question, participants answered “Not at all,” “Some,” or “Very 

Much.” Over 90% of participants reported that they found the workshops and materials very useful, 

and 46% ‐ 83% were currently using the tools and activities in their classrooms. 

Figure 119: Percentage of Participants Who Responded “Very Much” to Workshop 

Survey Questions 

First Workshop: 

Book and print rules - Big 

Book Song book & flannel 

board story 

Second Workshop: 

Social-emotional 

development and 

vocabulary 

Third Workshop: 

Book and print rules - 

Writing and counting 

activities 

Fourth Workshop: 

Non-fiction books - 

Repeated Read Aloud 

strategy 

Please tell us if you are using these name 

activities/games in your program? (N=11) 

How useful do you find this tool? (N=11) 

How useful was this workshop in supporting your 

knowledge with oral language? (N=12) 

Did you find the activities/games useful and 

appropriate? (N=12) 

Are you using the game board and vocabulary 

cards? (N=12) 

How useful was this workshop in supporting 

thinking skills? (N=13) 

With what frequency are you using the activities 

made? (N=13) 

How useful was this workshop in supporting writing 

around the room? (N=13) 

How many times do you read to your group of 

children in one day? (N=13) 

Source: Literacy Continuing Education Workshops survey data, Spring 2011. No survey was conducted in Fall 2010. 

46.2% 

69.2% 

90.9% 

90.9% 

83.3% 

91.7% 

91.7% 

92.3% 

0% 20% 40% 60% 80% 100% 

100.0% 



Migrant Education – Summer Pre‐K Academy 



CHILDREN LEARNING AND READY FOR SCHOOL ‐ MIGRANT EDUCATION – SUMMER PRE‐K ACADEMY 

Migrant education implements a four‐week summer academy for children about to enter 

kindergarten at seven Pajaro Valley Unified School District (PVUSD) elementary school sites. The 

program is for children who do not qualify for Migrant 

Education and who have little or no preschool 

experience. The academy is geared toward exposing 

children to early literacy concepts and kindergarten 

routines, in a safe learning environment that helps to 

support children’s emotional and social well‐being and 

build bonds with other children to ease later 

adjustments. 



Children 156 

Source: (Parents/Guardians) ; (Children) SUN database/CCD data for July 1, 2010 – June 30, 2011. 

“We are most proud of the growth our 

students have demonstrated after 

participating in the program. This growth can 

be seen in the pre and post data, parent 

feedback, and anecdotal feedback from 

teachers at the beginning of school. 

As well documented in the research literature, 

we are confident that these programs are 

changing the long term achievement and 

success of our students..” 

- Migrant Education, Annual Progress Report 

Outcome Objective: Children will increase their recognition of letter sounds 

Program Objectives 

75% of participants who completed both the pre and post survey 

will increase their letter sound recognition by 5 letter sounds using 

the cognate alphabet in the child’s home language. 

All Children 


90.4% 

Children 

attending at least 

14 sessions 

Source: Migrant Education – Summer Pre‐K Academy, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2011. 

N=94 

92.9% 

As seen in the following figure, in 2011, over 90% of all students who participated in the Summer 

Pre‐K Academy increased their letter sound recognition by at least five letter sounds, and this rose 

to almost 93% for children who attended at least 14 sessions. On average, students learned to 

recognize 16 new letter sounds by the time they left the program. 

N=85 

163


CHILDREN LEARNING AND READY FOR SCHOOL ‐ MIGRANT EDUCATION – SUMMER PRE‐K ACADEMY 

Figure 120: Summer Pre-K Academy Letter Sound Identification Results, 2011 

Percentage of Students who Increased Their Letter 


100% 

80% 

60% 

40% 

20% 

0% 

All Students 

90.4% 

92.9% 

Students who attended at least 14 sessions 

Average Number of Letter Sounds Recognized at Pre 

and Post Assessment 

17.2 17.2 

1.0 1.1 

Source: Migrant Education – Summer Pre‐K Academy, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2011. 

All Students N=94. 14 or more sessions Students N=85. 

Results for the past five years show a consistent pattern of learning, with 75%‐90% of students 

increasing their letter sound recognition by at least 5 letter sounds, and increases in recognition of 

from 11‐16 letter sounds. 

Figure 121: Percentage of Summer Pre-K Academy Students who Increased Their Letter 


100% 86.9% 83.8% 

90.4% 92.9% 

82.5% 81.9% 83.0% 

75.4% 

80% 

60% 

40% 

20% 

0% 

Figure 122: Average Increase in the Number of Letter Sounds Recognized by Summer 

Pre-K Academy Students 

20 

15.4 15.5 

14.9 

16.2 16.1 

16 

13.9 

12.4 


12 

8 

4 

0 

Source: Migrant Education – Summer Pre‐K Academy, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2007 ‐ 2011. 

Note: Between 2006 and 2009, the Summer Pre‐K Academy was a 5‐week program. Beginning in 2010, it became a 4‐week program. 

All Students N: 2007=84, 2008=80, 2009=114, 2010=65, 2011=94. 14 or more sessions Students N: 2009=94, 2010=47, 2011=85; no data for this 

population are available for 2007 and 2008. 


20 

15 

10 

5 

0 

All Students Students who attended at 

least 14 sessions 

Pre Post 


All Students Students who attended at least 14 sessions 


All Students Students who attended at least 14 sessions


Migrant Education School Readiness Program 



CHILDREN LEARNING AND READY FOR SCHOOL ‐ MIGRANT EDUCATION SCHOOL READINESS PROGRAM 

The Migrant Education School Readiness Program (MESRP) offers a mechanism for ensuring that 

at‐risk children and families will have the support they need to prepare them for a successful 

transition to formal schooling, by providing a high‐quality early childhood program that includes: 

� An effective evidence‐based, culturally responsive curriculum grounded in empirical knowledge. 

� Developmentally appropriate instruction and strategies, including those specific to Dual 

Language Learners. 

� Alignment with high ECE standards as set forth by the California Preschool Learning 

Foundations. 

� High quality professional development and ongoing support through coaching for the staff. 

� A needs assessment to ensure that the program is responsive to the needs of the families. 

� An ongoing partnership between the families, the school, and community services. 

The MESRP program improves outcomes for both children and parents by supporting the child’s 

preparedness for formal schooling and strengthening the parent‐child relationship. 



Children 36 


Outcome Objective: Children will increase their recognition of letter sounds 

Program Objectives 

75% of participants who completed both the pre and post 

survey and have attended consistently, will increase their letter 

sound recognition by 10 letter sounds in their home language. 


English Assessment Home Language Assessment 

75.0%* 

Source: Migrant Education School Readiness Program: English assessment, Phonological Awareness Literacy Screening (PALS) tool, 2011; Home 

language assessment, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2011. 

* English language results should be interpreted with caution due to the low number of cases. 

Two similar assessments were used to measure children’s recognition of letter sounds; the 

Phonological Awareness Literacy Screening (PALS) tool measured children’s ability to identify letter 

sounds in English, and the Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification 

tool measured children’s letter sound recognition in their home language. In 2011, 75% of students 

N=8 

80.0% 

N=30 

165



who participated in the Migrant Education School Readiness Program (MESRP) increased their letter 

sound recognition in English by at least 10 letter sounds, and this rose to almost 80% for children 

who took the assessment in their home language. On average, students learned to recognize 18 new 

letter sounds by the time they left the program. 

Figure 123: MESRP Letter Sound Identification Results, 2011 

Percentage of Students who Increased Their Letter 


Average Number of Letter Sounds Recognized at Pre 

and Post Assessment 

Source: Migrant Education School Readiness Program: English assessment, Phonological Awareness Literacy Screening (PALS) tool, 2011; Home 

language assessment, Migrant Education Even Start (MEES) Pre‐K Letter Sound Identification tool, 2011. 

English language N=8; Home language N=30. 

* English language results should be interpreted with caution due to the low number of cases. 

Outcome Objective: Children will demonstrate progress in early learning skills 

The Brigance Preschool Screen ‐ II assessment was utilized by the Migrant Education School 

Readiness Program (MESRP) to identify children’s present level of performance, set goals, and 

measure progress in domains that align to early learning standards. Through verbal questions, 

drawing, and physical activities, children were given a series of age‐appropriate assessments that 

provided a sampling of their learning, development, and skills in a broad range of areas, such as fine‐ 

motor skills, body awareness, general knowledge, language development, and gross‐motor skills. 

Results show that students’ average scores on the Brigance Preschool Screen increased from 60.4 to 

79.3, demonstrating an overall improvement of 31% in their early learning skills. 

100 

80 

60 

40 

20 

0 

100% 

80% 

60% 

40% 

20% 

0% 

75.0% 

80.0% 

English Language* Home Language 

Figure 124: MESRP Students’ Average Scores on the Brigance Preschool Screen-II 

Assessment 

60.4 

Average Scores 

79.3 

Pre Post 

Source: Migrant Education School Readiness Program: Brigance Preschool Screen ‐ II assessment, 2011. 

N=24. 


30 

25 

20 

15 

10 

5 

0 

8.0 

26.1 

1.7 

20.3 

English Language* Home Language 

Pre Post




Outcome Objective: Children will improve their listening comprehension for 

spoken words 

The Peabody Picture Vocabulary Test was utilized by the Migrant Education School Readiness 

Program (MESRP) to measure children’s listening comprehension for spoken Standard American 

English. The test is administered by showing a series of pictures to the child, with four pictures to a 

page. The examiner states a word describing one of the pictures and asks the child to indicate which 

picture that word describes. Raw scores are calculated and can be used for comparison in Pre/Post 

tests. 

Results show that students’ average scores on the Peabody Picture Vocabulary Test increased from 

73.4 to 84.4, demonstrating a 15% increase in their listening comprehension for spoken English 

words. 

100 

80 

60 

40 

20 

0 

Figure 125: MESRP Students’ Average Scores on the Peabody Picture Vocabulary Test 

73.4 

Average Scores 

84.4 

Pre Post 

Source: Migrant Education School Readiness Program: Peabody Picture Vocabulary Test, 2011. 


N=7. 

167


CHILDREN LEARNING AND READY FOR SCHOOL ‐ PVUSD PARENT CONFERENCE 

Pajaro Valley Unified School District (PVUSD) Parent Conference 


In February 2011, First 5 co‐sponsored the Pajaro Valley Unified School District’s Parent Conference. 

The annual event brings together parents of children of all ages to learn how they can support their 

children’s learning. Families participated in workshops promoting transition to kindergarten 

practices, healthy child development, and positive discipline. 



Number of families attending this Conference 318 families 

Percentage of families with children ages 0‐5 55% with children ages 0‐5 

Source: Pajaro Valley Unified School District, 2011. 



Transition to School Workshops 



CHILDREN LEARNING AND READY FOR SCHOOL ‐ TRANSITION TO SCHOOL WORKSHOPS 

Transition to School Workshops are offered to families in preschool settings. These workshops are 

designed to inform parents about kindergarten registration requirements, choices of language 

programs, how to support their child in school, and ways to ensure that their child’s entry into 

school is a pleasant and smooth transition. 

Families participated in workshops at five elementary schools (Alianza, Freedom, Landmark, Radcliff, 

and Starlight) and at early education sites throughout Watsonville. Parents also participated in 

workshops at 13 Head Start and State Preschool sites throughout Watsonville and Freedom. 




Source: Transition to School – Workshop Schedule and Participant Data, 2010‐ 2011. 

169


CHILDREN LEARNING AND READY FOR SCHOOL ‐ TRANSITION TO SCHOOL WORKSHOPS 


FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT APPENDICES 

APPENDICES 


171

APPENDICES FIRST 5 SANTA CRUZ COUNTY 2010‐2011 ANNUAL EVALUATION REPORT 



Appendix I: First 5 Santa Cruz County Strategic Framework 

Based on the First 5 Santa Cruz County Strategic Plan for 2009‐2012, a strategic framework was 

developed for each of the three goal areas (Healthy Children, Strong Families, and Children Learning 

and Ready for School). The highlighted results have been chosen to receive Commission investment 

between 2009 and 2012. This diagram is an expanded version of that which is presented previously 

in this report. 

Focus Area 

Community 

Goals 

Results 


Increase 

Prenatal 

Care 

Children are 

Born Healthy 

Healthy 

Children 

Increase 

Insurance 

Coverage Increase 

Medical/ Dental 

Homes 

Decrease 

Childhood 

Obesity 

Increase Number of 

Children Reaching 

Developmental 

Milestones 

Children Remain 

Healthy 

Decrease Family 

Food Insecurity 

Increase use of 

Preventive 

Health Care 

Increase Smoke 

Free Homes 

173


Focus Area 

Community 

Goals 

Results 

Focus Area 

Community 

Goals 

Results 

Decrease Parent/ 

Guardian 

Substance Abuse 

Increase 

Parental 

Involvement 

in Children’s 

Learning & 

Development 

Increase Access to 

Child Care/Preschool 

Children Live 

in Safe 

Environments 

Decrease Child Abuse 

& Neglect 

Decrease Child 

Exposure to Domestic 

Violence 

Children Grow Up in Environments 

that Support Learning 

Increase 

Participation 

in Quality 

Structured 

Activities 

Increase Use 

of Quality 

Child Care 

Practices 


Improve Parent & Caregiver 

Practices that Support Social 

and Emotional Development 

Decrease Impact 

of Parental 

Mental Illness 

Children Learning and 

Ready for School 

Improve 

Pre‐ 

Literacy 

Skills 

Decrease Family 

Financial 

Insecurity 

Children are Socially 

and Emotionally 

Healthy 

Schools are Ready for Children 

Increase Identification 

& Accommodation of 

Children with Special 

Needs 

Increase Use of 

Kindergarten 

Transition 

Practices 

Reduce Family 

Isolation 



Appendix II: Measurement Tools 

The following assessments and measurement tools were used to collect evaluation data during this 

funding cycle. They are listed in alphabetical order. 

Ages & Stages Questionnaires (ASQ) 

The Ages & Stages Questionnaires ® (ASQ) are used to screen infants and young children for 

developmental delays during the crucial first five years of life. Parents complete the 30‐item 

age‐appropriate questionnaires at designated intervals, assessing children in their natural 

environments to ensure valid results. Each questionnaire covers five key developmental 

areas: communication, gross motor, fine motor, problem solving, and personal‐social. 26 

Ages & Stages Questionnaires: Social Emotional (ASQ:SE) 

Ages & Stages Questionnaires ® : Social‐Emotional (ASQ:SE) focus on children’s social and 

emotional behavior. Professionals assess children’s social‐emotional development at 

different ages (at 6, 12, 18, 24, 30, 36, 48, and 60 months). ASQ:SE screening areas focus on 

personal‐social skills (self‐regulation, compliance, communication, adaptive functioning, 

autonomy, affect, and interaction with people). With the results, professionals can recognize 

young children at risk for social or emotional difficulties, identify behaviors of concern to 

caregivers, and identify any need for further assessment. 27 

Brigance Preschool Screen - II 

The Brigance Preschool Screen ‐ II (Curriculum Associates, 2005) was utilized by the PVUSD 

Migrant Education School Readiness Program to identify children’s present level of 

performance, set goals, and measure progress in domains that align to early learning 

standards. Through verbal questions, drawing, and physical activities, children are given a 

series of age‐appropriate assessments that provide a sampling of their learning, 

development, and skills in a broad range of areas, such as fine‐motor skills, body awareness, 

general knowledge, language development, and gross‐motor skills. The primary purpose of 

screening is to obtain a broad sampling of a child’s skills and behaviors for one or more of the 

following reasons: 

1. To identify any child who should be referred for a more comprehensive evaluation to 

determine the existence of a disability or the need for special placement 

2. To help determine the most appropriate initial placement or grouping of children 

3. To assist the teacher in planning a more appropriate program for the child 

4. To comply with mandated screening requirements 

The Brigance Preschool Screen ‐ II assessment is currently only available in English. 

26 

Brookes Publishing, Ages & Stages Questionnaires® (ASQ), http://www.brookespublishing.com/store/books/bricker-asq/, 2007. 

27 

Brookes Publishing, Ages & Stages Questionnaires‐Social Emotional (ASQ:SE), http://www.brookespublishing.com/store/books/squiresasqse/index.htm, 

2007. 


175


Child Behavior Checklist (CBCL) 

The Child Behavior Checklist (CBCL; Achenbach, 1991; 2001) is part of the Achenbach System 

of Empirically Based Assessment. The CBCL is a screening tool which is used by parents (and 

in mental health settings) to assess behavioral and emotional problems in children and 

adolescents. 

The Child Behavior Checklist (CBCL) contains about 100 items that can cluster into several 

syndromes, competence scales, codes from the Diagnostic and Statistical Manual of Mental 

Disorders, 4th Edition (DSM‐IV). Children are ranked according to the severity of behavior, 

thus percentile rankings tell us how a child, or group of children, compare to the general 

population. Higher percentile rank indicates more problematic behavior. Rankings falling 

between the 65th and 70th percentile indicate “Borderline Clinical”; the 70th percentile rank 

and above denote the clinical range. Clients who score at or near the clinical range are more 

likely to have or develop a clinical diagnosis. Thus, the CBCL serves as an indicator of clinical 

risk based on the degree of similarity with other children who have received (or have not 

received) a diagnoses. A significant drop in percentile rank indicates a decrease in clinical risk. 

The CBCL has good psychometric properties and has been validated internationally. This tool 

is helpful in determining children who might benefit from additional assessment and mental 

health services. 

Child Snapshot 

The Kinder Transition Team Child Snapshot was a strategy within the Transition to School 

Plan and was identified by the Transition to School Advisory group in July 2005 as one that 

could help support children’s adjustment to kindergarten. The Snapshot was completed by 

parents and early care teachers for each child entering kindergarten in the fall, and was 

forwarded on to the child’s new kindergarten teacher. The form included brief (snapshot) 

information about the child’s interests and abilities, the child’s health, language or 

developmental concerns, preschool experience, and other developmental information. The 

form was expanded in 2009‐10 to include additional information such as family activities and 

community supports for parents. A measurement of kindergarten readiness was also 

included at the end of the Child Snapshot, using either the Desired Results Developmental 

Profile‐R Preschool or the Pre‐Kindergarten Observation Form, depending upon the child care 

site within Santa Cruz County (both of these assessments are described below). 

Depression, Anxiety, Stress Scale (DASS-21) 

The Depression, Anxiety, and Stress Scale – Short Version (DASS‐21) was utilized by 

participants in levels 4 and 5 of the Triple P Program. It is a 21‐item brief version of the 

Depression Anxiety Stress Scales (Lovibond & Lovibond in 1995). It is a self‐report measure 

used to assess the levels of depression, anxiety, and tension/stress experienced, which was 

completed by parents in the program. Respondents indicate how much they felt each of the 

21 symptoms during the previous week. The scale is psychometrically sound – it has good 



convergent and discriminant validity. It also has high internal consistency in clinical and non‐ 

clinical samples, and across different ethnic groups. 

Desired Results Developmental Profile 

The Desired Results Development Profile was created as a comprehensive program 

evaluation system designed to measure California Department of Education funded child 

development contractor effectiveness. Desired results reflect the positive effects of the child 

development system on the development and functioning of children and on the self‐ 

sufficiency and functioning of families 28 . The DRDP is an observation‐based assessment and is 

organized into several domains, each representing a crucial area of learning and 

development. Each domain contains several measures, which focus on a specific competency 

within that domain. There are three DRDP assessment instruments: infant/toddler (birth to 

36 months), preschool (three years to kindergarten entry), and school‐age (kindergarten 

through 12 years); two of these assessments were used by First 5 partners: 

a) Desired Results Developmental Profile – Infant/Toddler (2010) 

The DRDP – Infant Toddler (2010) is used for children ages birth to 36 months, and measures 

five domains. The Starlight Infant Toddler Program chose to assess the infants and toddlers 

participating in their program in two domains, using a total of eight measures. In the Self and 

Social Development domain, two measures were used to assess interactions and 

relationships with adults. In the Language and Literacy Development domain, six measures 

were used to assess language comprehension, communication skills, interest in literacy, and 

recognition of symbols. 

b) Desired Results Developmental Profile - Revised, Preschool (DRDP-R, PS) 

The DRDP – Preschool Version is used for children 3 years of age to kindergarten entry. The 

DRDP‐PS has 10 overall indicators, containing 39 measures. This version of the DRDP 

instrument was used in conjunction with the Child Snapshot (see Child Snapshot, above). 

Early Language and Literacy Classroom Observation Pre-K Tool 

(ELLCO Pre-K) 

The first version of the ELLCO (ELLCO Toolkit) was designed to evaluate the teaching practices 

of early childhood educators in the areas of language and literacy, in pre‐kindergarten to 

third‐grade classrooms. 29 The newest version of the tool (ELLCO Pre‐K) is comparable to the 

ELLCO Toolkit, and has been reorganized so that it reduces the bias towards classrooms that 

28 California Department of Education. (2009). Introduction to desired results. Retrieved from 

http://www.cde.ca.gov/sp/cd/ci/desiredresults.asp 

29 Education Development Center, Inc., Center for Children and Families, Early Language and Literacy Classroom Observation Toolkit, 2002. 


177


have a lot of resources, and focuses more on the use of materials rather than just their 

presence in the preschool classrooms. 30 

The ELLCO Pre‐K was used by the Early Literacy Foundations to help identify the effectiveness 

of classroom teaching on children’s language and literacy development by focusing on five 

components: Classroom Structure, Curriculum, the Language Environment, Books and Book 

Reading, and Print and Early Writing. 

Eyberg Child Behavior Inventory Intensity Scale (ECBI) 

The Eyberg Child Behavior Inventory Intensity Scale (ECBI; Eyberg & Pincus, 1999) was utilized 

by participants in levels 4 and 5 of the Triple P Program. The ECBI is a 36‐item parent report 

measure of behavior problems among children. Parents indicate the frequency of common 

behavior problems, such as wetting the bed, whining, or having temper tantrums. Parents 

indicate how frequently each of the problem behaviors occur (from never to always) and 

whether or not they feel that the behavior is a problem (yes or no). The ECBI has good 

psychometric properties (reliability and validity). The ECBI is useful in determining children 

that may have a diagnosable disruptive behavior disorder, as well as for helping intervene to 

reduce early behavior problems and to reduce negative parent‐child interactions that may 

contribute to the development of disruptive behavior problems 31 . 

Family Child Care Environment Rating Scale, Revised Edition (FCCERS-R) 

The Family Child Care Environment Rating Scale – Revised Edition (FCCERS–R) assesses family 

child care programs conducted in a provider’s home, and is designed to ensure protection of 

children’s health and safety, appropriate stimulation through language and activities, and 

warm, supportive interaction. The 38 items are organized into seven subscales: Space and 

Furnishings, Personal Care Routines, Listening and Talking, Activities, Interaction, Program 

Structure, and Parents and Provider. First 5 Santa Cruz County is tracking four of these 

indicators: helping children understand language; helping children use language; using books; 

and staff‐child interaction. Since family child care homes frequently enroll a wide age range 

of children, this scale is designed to assess programs serving children from birth through 

school‐agers (up to 12 years of age), as well as children with special needs, and is sensitive to 

cultural and socioeconomic diversity. 32 

Healthcare Effectiveness Data and Information Set (HEDIS) Indicators 

First 5 uses the Healthcare Effectiveness Data and Information Set (HEDIS) data to track the 

quality of care that children enrolled in Healthy Kids are receiving in Santa Cruz County. A 

total of 10 health care quality indicators are requested annually by First 5 California and the 

30 

Review by Maria Cahill (University of Tennessee), of the User’s Guide to the Early Language & Literacy Classroom Observation Pre‐K Tool, 

Education Book Review website. 

31 

Berkovits, M. D., O’Brien, K. A., Carter, C. G., & Eyberg, S. M. (2010). Early identification and intervention for behavior problems in 

primary care: A comparison of two abbreviated versions of parent‐child interaction therapy. Behavior Therapy, 41, 375 – 387. 

32 

Environment Rating Scales – Family Child Care Environmental Rating Scale, Revised Edition: http://www.fpg.unc.edu/~ECERS/. 

September 18, 2009. 



California Endowment from every operating Healthy Kids insurance plan based on data 

entered into HEDIS. HEDIS is a “set of standardized performance measures designed to 

ensure that purchasers and consumers have the information they need to reliably compare 

the performance of managed health care plans.” 33 

Individual Growth and Development Indicators (IGDI’s) 

Individual Growth and Development Indicators (IGDI’s) are a set of measures designed and 

validated for use by early education professionals for the purpose of monitoring children’s 

growth and progress in early reading predictors. Unlike standardized tests that are 

administered infrequently, IGDI’s is designed to be used repeatedly by early childhood 

educators in order to estimate each child’s “rate of growth” over time. The distinctive benefit 

of this approach is that the information can be used to directly inform intervention design, 

implementation, and modification at reasonable levels of training, time, and cost. The tools 

provide helpful information about children’s growth in three key areas of reading predictors: 

picture naming (a measure of vocabulary development), rhyming, and alliteration. 

Infant/Toddler Environment Rating Scale, Revised Edition (ITERS-R) 

The Infant/Toddler Environment Rating Scale ‐ Revised Edition (ITERS‐R) is designed to assess 

early childhood educators working with children from birth to 30 months of age. ITERS‐R 

contains items to assess provision in the environment for the protection of children’s health 

and safety, appropriate stimulation through language and activities, and warm, supportive 

interaction that play an important role in improving the quality of infant/toddler care. ITERS‐ 

R is composed of 39 items that are organized into seven subscales: Space and Furnishings, 

Personal Care Routines, Listening and Talking, Activities, Interaction, Program Structure, and 

Staff. 34 First 5 Santa Cruz County is tracking four of these indicators: helping children 

understand language; helping children use language; using books; and staff‐child interaction. 

Literacy Continuing Education Workshops: Evaluation Survey 

Early childhood educators who complete the SEEDS of Early Literacy classes can continue 

receiving professional development through the Literacy Continuing Education Workshops, 

where they make activities and materials that will enhance their work environment and 

promote literacy with young children. In this program, four workshops are provided, each 

with a different focus. At the end of the program, early childhood educators are asked to 

complete an Evaluation Survey that includes questions about each of the workshops, 

including how useful they were and what they liked best. Three additional open‐ended 

questions are asked about how the workshops support them in their work with children, 

what they like most about these workshops, and what recommendations they might have to 

improve these workshops. 

33 ® 

The Health Plan Employer Data and Information Set (HEDIS ), http://www.ncqa.org/Programs/HEDIS/index.htm, 2007. 

34 

Environment Rating Scales – Infant/Toddler Environmental Rating Scale, Revised Edition: http://www.fpg.unc.edu/~ECERS/. September 

18, 2009. 


179


Migrant Education Even Start (MEES) Pre-K Letter Sound Identification 

Children attending the Migrant Education – Summer Pre‐K Academy and the School 

Readiness Program are assessed using the Pre‐K Letter Sound Identification tool, which is 

used to assess letter sound recognition in the child’s primary language. The MEES tool is a 

pre‐ and post‐program survey that allows early childhood educators to circle those letters for 

which the child can say the sound (not the name of the letter). Changes in children’s 

outcomes are evaluated by comparing the scores between their baseline and final 

assessments. 

Parent Problem Checklist 

The Parent Problem Checklist (Dadds & Powell, 1991) was utilized by Levels 4 and 5 of the 

Triple P Program. It is a 36‐item self‐assessment measure of parental and relationship 

conflict, completed by each parent. For each issue (e.g. disagreement over household rules), 

parents identify if the issue has been a problem (yes or no), and the extent to which the issue 

has been a problem, from not at all, to very much. It has been shown to have high internal 

consistency, test‐retest reliability, and convergent validity. 

Parenting Experience Survey 

The Parenting Experiences Survey (Sanders et. al., 1999) was utilized by Level 3 of the Triple P 

Program. It is a self‐report measure of issues related to being a parent, and was completed 

by parent participants. It consists of 7 items and assesses parents’ experiences related to 

issues such as how difficult they perceive their child to be, how stressful they feel parenting 

to be, and how rewarding they feel parenting to be. There are 3 items which are specific to 

parents that have a partner. Those items are used to assess agreement on discipline, partner 

support, and relationship happiness. This survey is not used as the primary measure for any 

of the variables that it measures, but it has been used to show changes in parental attitudes 

and behaviors from the beginning to the completion of the Triple P Program. 

Parenting Scale 

The Parenting Scale (Arnold, O’Leary, Wolff & Acker, 1993) was utilized by Levels 4 and 5 of 

the Triple P Program. It is a measure of parenting styles for handling child misbehavior, 

completed by parents. It consists of 30 items, which are grouped into 3 subscales: laxness, 

over‐reactivity, and hostility. The Parenting Scale has good test‐retest reliability, discriminant 

validity, and correlates with other self‐report measures of child behavior, marital discord, 

and child behavior. 

Parenting Tasks Checklist 

The Parenting Tasks Checklist was utilized by Levels 4 and 5 of the Triple P Program. It is a 

self‐report measure of confidence in parenting abilities, completed by parents. It is a 28‐item 

scale in which parents rate their confidence (from 0 – Certain I can’t do it to 100 – Certain I 



can do it), across a range of difficult child behaviors, such as managing their child when the 

child becomes upset, or when traveling in a car. 

Parent’s Attribution for Child’s Behavior Measure 

The Parent’s Attribution for Child’s Behavior Measure (Pigeon & Sanders, 2004) was utilized 

by Level 5 of the Triple P Program. It is a self‐report measure of attributions for children’s 

behaviors. The instrument consists of 6 hypothetical situations describing different types of 

difficult child behavior, with 4 questions related to each situation. The questions for each 

situation relate to innateness of the child’s behavior, the child’s intentionality, and the 

blameworthiness of the child. The total score and the 3 subscale scores for this tool have 

good internal consistency and discriminant validity. 

Peabody Picture Vocabulary Test, 4 th Edition (PPVT-4) 

The Peabody Picture Vocabulary Test (Dunn & Dunn, 2007) is a norm‐referenced test of 

receptive vocabulary, and was utilized by the PVUSD Migrant Education School Readiness 

Program to measure children’s listening comprehension for spoken Standard American 

English. It requires no reading or writing. The test is administered by showing a series of 

pictures to the child, with four pictures to a page. The examiner states a word describing one 

of the pictures and asks the child to indicate which picture that word describes. Children 

complete as many series of pictures as they can until a “ceiling set” is reached, based on the 

number of errors they are making. At that point, raw scores are calculated as the total 

number of items that child completed minus the total number of errors. Raw scores can be 

used for comparison in Pre/Post tests, or converted to standard scores, percentile ranks, or 

age equivalents. The PPVT‐4 assessment is currently only available in English. 

Phonological Awareness Literacy Screening (PALS) 

Migrant Education used the letter ID component of the Phonological Awareness Literacy 

Screening (University of Virginia, 2004) as an assessment tool in their School Readiness 

Program, to measure letter sound knowledge. The PALS assessment is currently only 

available in English, so this assessment was often combined with the MEES Pre‐K Letter 

Sound Identification tool, which is available in both English and Spanish. 

Pre-Kindergarten Observation Form (P-KOF) 

The Pre‐Kindergarten Observation Form (P‐KOF) was originally developed by Applied Survey 

Research in 2001 using guidelines from the National Education Goals Panel (NEGP) 

framework of readiness. Since 2001, four additional skills have been added to better capture 

children’s skills at negotiation, coping, empathy, and handling frustration. The Pre‐ 

Kindergarten Observation Form is a 24‐item, observation‐based assessment used by child 

care providers to assess children on readiness skills pertaining to kindergarten academic 

skills, social expression, self‐regulation, and self‐care and motor skills. Child care providers 

were asked to observe and score each child according to his or her level of proficiency in 


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each skill, ranging from not yet to proficient (with an option of don’t know/not observed for 

each item). The P‐KOF has been shown to have good reliability and validity. The instrument 

was attached to the back of the Child Snapshot, and was utilized at certain sites within Santa 

Cruz County. 

Raising A Reader: Parent Impact Survey 

The Parent Impact Survey was utilized by the Raising A Reader Program. It is a self‐report 

measure of parent and child engagement with books and library use. It consists of 29 items 

related to reading in the home, use of book bags, and parent‐child reading practices. Items 

assess current practices but there are also retrospective items which assess parent and child 

reading practices before program participation. 

Relationship Quality Index 

The Relationship Quality Index (Norton, 1983; also known at the Quality Marriage Index) was 

utilized by Levels 4 and 5 of the Triple P Program. It is a self‐report measure of relationship 

satisfaction, and was completed by parents. It consists of six statements related to 

dimensions of relationship satisfaction such as happiness, strength, and stability. 

Respondents indicate how much they agree or disagree with each statement, ranging from 

very strongly disagree, to very strongly agree. 

Santa Cruz County Services Unifying Network (SCC SUN) Database / 

CCD Data 

Funded partners were required to submit information on a quarterly or biannual basis on the 

program participants who they directly served. Client characteristic data (CCDs) were 

gathered in one of two ways, the SCC SUN database, and partner‐specific data collection 

forms. 35 

o The SCC SUN database was launched on January 1, 2004, and some partner agencies used 

this database to record their clients’ data. The database was integrated, meaning that 

information could be shared between agencies, if the appropriate consent was obtained. 

Demographic information about these clients could then be extracted for analysis, using 

unique IDs that maintained clients’ anonymity. 

o Partner agencies not using the SCC SUN database collected and submitted demographic 

data in partner‐specific data collection forms. 

In the course of evaluating these data, a “cleaning” process was performed. In this process, 

each program’s data were standardized to use the same response sets, reviewed for accuracy 

and completeness, and corrected wherever possible. These data were then migrated to a 

customized statistical database that aggregated them and determined the unduplicated 

count of individuals served by goal area, partner agency, and overall. Each client 

35 In this report, all client characteristic data (CCDs) collected from both the SUN database and partner‐specific data collection forms, that 

were then combined and comprehensively analyzed, are collectively referred to as “SUN database/CCD data.” 



characteristic was analyzed, with results that reported the total number of individuals with 

data for that variable, and the frequency and percentage of each response to that variable. 

o Children’s ages were determined in these ways: 

� For all partners except Triple P, children’s ages were calculated as of the first day of 

the funding cycle. This enabled all children ages 0‐5 to be included in the analyses, 

even if they turned six years old later in the year. Children not yet born by the first 

day of the funding cycle (i.e., born later in the funding cycle) were also included in 

the analyses and categorized as being under one year of age. 

� For Triple P children, their ages were calculated as of the date of their parent’s first 

assessments (“Pre‐assessments”), or the date of their single program session. This 

date was chosen since many Triple P assessments required that the child be within a 

certain age range for the parent to complete it. Therefore, a more exact 

determination of the child’s age as of the date of the assessment was needed in 

order to identify whether or not it was appropriate to include those data in the 

analysis of that assessment. 

o The cities where clients lived were organized into the following sub‐county areas: 


SUB‐COUNTY AREA CITIES 

North County Bonny Doon, Capitola, Davenport, Live Oak, Santa Cruz, Scotts Valley, Soquel 

South County Aptos, Corralitos, Freedom, La Selva Beach, Seacliff, Watsonville 

San Lorenzo Valley Ben Lomond, Boulder Creek, Brookdale, Felton, Mount Hermon 

Structured Decision Making (SDM) 

The Structured Decision Making (SDM) model is a set of assessments for guiding decision‐ 

making at each of the decision points for children in Families Together. One assessment is the 

SDM Family Prevention Services Screening Tool (FPSST), used to make two decisions: 

whether or not to offer voluntary prevention services and, if so, the frequency of ongoing 

case manager contact. The screening tool identifies families who have low, moderate, high, 

or very high probabilities of future abuse or neglect. The risk level identifies the degree of risk 

of future maltreatment, guides the decision to offer voluntary prevention services, and helps 

determine the frequency of case manager contact. 36 

The SDM:FPSST is also used to reassess a family in order to make two decisions: whether or 

not to continue voluntary prevention services past 12 months for these families receiving 

intensive services, and past 3 months for those receiving a brief intervention and, if so, the 

frequency of case manager contact. 37 

36 Children’s Research Center, Structured Decision Making Policy and Procedure Manual, p. 12, 2006. 

37 Children’s Research Center, Structured Decision Making Policy and Procedure Manual, p. 31 & 36, 2006. 

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Triple P: Program-Specific Assessments 

Satisfaction Survey 

Multiple Sessions (Individual or Group) 

The Multiple Sessions Satisfaction Survey was utilized for parents who completed Levels 3, 4, 

and/or 5 of the Triple P Program. It consists of 16 items – 13 closed‐ended items and 3 open‐ 

ended items. Parents assessed many different dimensions of the program including: the 

quality of the program, the extent to which the program met their needs and their child’s 

needs, how much the program helped parents deal with problems in their family or with 

their children, relationship improvement, child behavior improvement, and overall 

satisfaction. 

Single Sessions (Seminars & Workshops) 

The Single Session Satisfaction Survey was utilized for the Level 2 Seminars and Level 3 

Workshops of the Triple P Programs. It consists of 4 items – 3 closed‐ended questions, and 1 

open‐ended question. Participants filled out this short survey which assessed if they felt that 

the seminar or workshop addressed their questions, whether they were going to use any of 

the parenting strategies they learned, and if they were satisfied, overall, with the seminar or 

workshop. Participants could also add any additional comments they had. 

Follow-Up Phone Survey 

Parents and guardians who completed certain Triple P programs were given the option of 

voluntarily participating in a follow‐up phone survey six months and one year later, to help 

determine the long‐lasting effects of these programs on their parenting skills and 

experiences. This survey consisted of 18 questions, some with multiple parts, that asked 

about their parenting abilities and effectiveness in dealing with certain parenting problems, 

their confidence in their parenting skills, the Triple P strategies that they are currently using, 

changes in their child’s behavior, and where applicable, their relationship with and support 

from their partner. Participants were also given the option of commenting on their 

experience with the program. Participants who completed the survey were given a $25 gift 

certificate to Target. 

Effectiveness of Staff Training 

In addition to offering structured trainings to practitioners, Triple P America also provides 

measures to assess the effectiveness of such trainings. The first measure is a Parent 

Consultation Skills Checklist (PCSC), an instrument to gauge changes in practitioners’ ability 

and confidence to conduct parent consultations. The second instrument, a Workshop 

Evaluation Survey, is a measure of practitioners’ satisfactions with the trainings. 



Parent Consultation Skills Checklist 

The Parent Consultation Skills Checklist (PCSC) was used to measure Triple P practitioners’ 

self‐efficacy, or perceived competency, in core skills including assessment, active skills 

training, dealing with process issues, and clinical application of positive parenting strategies. 

Practitioners rated their proficiency on a 7‐point scale (1 = not at all confident or definitely 

not adequately trained, 7 = very confident or definitely adequately trained). The 

questionnaire was administered prior to beginning training (Pre), immediately after training 

(Post), and at the end of accreditation (Follow‐up). 

Workshop Evaluation Survey 

Triple P practitioners completed a Workshop Evaluation Survey at the end of each training 

and on completion of the accreditation process. The survey included a 7‐point scale (1 = low, 

7 = high) to assess the quality of the training course, whether the amount of active 

participation within the course was appropriate, the quality of the content of the training, 

whether respondents felt they had the skills to implement the program, and overall 

satisfaction with the training course. 


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