Tri-Fold Front Page: Photo of cute little girl both hand on her hip, holding stuffed animals. Project Kariñu Loving Our Babies Guam’s Early Childhood System of Care EVALUATION REPORT November 2015 Project Kariñu Vision Our children and families will have healthy minds, bodies, and spirits for lifelong success Inside Left Page: Project Kariñu Helps Young Children This report provides an annual update on the evaluation of Project Kariñu. Five years of evaluation data demonstrates that the children and families served by Project Kariñu have experienced positive outcomes. Fewer children experience serious emotional and behavioral challenges, and many caregivers reported improvements in their parenting skills and less stress associated with raising their child. Project Kariñu is an early childhood mental health program located within the Department of Public Health and Social Services. It offers a variety of services and supports for young children, birth – 5 years of age who experience challenges in their social, emotional, and behavioral development. From June 2011 – September 2015, over 524 children and their families have had contact with Project Kariñu through the referral process or outreach events. Project Kariñu uses a “system of care approach” to provide culturally and linguistically competent services that are child centered, family driven, and community based. It works closely with caregivers and other service providers so that services meet children’s unique needs and are coordinated and integrated. Services include: . outreach and referral; . screening and assessment; . individualized service planning, treatment, and interventions; and . family support and caregiver education. Characteristics of Children Receiving Services . Children as young as 2 months through 6 years . 62% are male and 38% are female . 75.4% are Chamorro or Chamorro mix; 8.8% are Filipino or Filipino mix; 7.1% are Chuukese; and 8.6% are from other cultural/ethnic groups . 32.6% are in foster care . 45.5% of children reside in households with an annual income of less than $25,000 % of Children with Risk Factors Family History of Depression 36.0% Family History of Substance Abuse 34.0% Witnessed Domestic Violence 28.0% Family History of Mental Illness other than Depression 18.4% Experienced Physical Assault 12.0% Experienced Sexual Assault 5.7% Children’s 5 Most Common Challenges Specific Developmental Disability 28.9% Disruptive Behaviors 27.4% Maltreatment 25.9% Adjustment 25.5% Parental/Caregiver Mental Health 17.9% Photo on right side: Little boy holding a Teddy Panda Bear. About This Report This report is the fourth in a series and summarizes findings from the evaluation of Project Kariñu from October 2009 – September 2015. Descriptive data is presented on 294 children/families from data collected using the Enrollment and Demographic Information Form. Outcome data is presented on children/families enrolled in the National longitudinal study. Center Page: Areas of Improvement Fewer Children Experience Serious Challenges Three Colored Bar Graphs 1st Graph: Bar Graph Legend: Blue: Intake; Green: 12 Months Emotionally Reactive: Intake: 25.4% 12 Months: 7.9% Withdrawn: Intake: 39.7% 12 Months: 15.9% Attention Problems: Intake: 30.2% 12 Months: 20.6% Aggressive Behavior: Intake: 32.3% 12 Months: 16.1% Data collected using the Child Behavior Checklist 1 1/2 - 5 (CBCL 1 1/2 -5). Caregiver report Intake to 12 Months. N = 63. 2nd Graph: Circle Graphs Legend: Blue: Improved; Green: Stayed the Same; Gray: Got Worse 51.3% Improved 41.0% Stayed the Same 7.7% Got Worse Data collected using the Child Behavior Checklist 1 1/2 - 5 (CBCL 1 1/2 -5). Caregiver report Intake to 18 Months. N = 39. 41.5% Caregivers Reported Feeling Less Stress Third Graph: Legend: Blue: Improved; Green Stayed the Same; Gray: Got Worse 41.5% Improved 56.1% Stayed the same 2.4% Got Worse Data collected using the Caregiver Strain Questionnaire (CGSQ). Caregiver report Intake to 24 Months. N = 41. Families Share How Project Kariñu Has Helped “I’m not reactive anymore; more calm, patient.” “Play therapy helps parents understand children’s feelings, to better help the child.” “I find it most helpful that Project Kariñu taught my son how to relate well with other kids. Taught him how to play instead of hurting others.” “My child is now listening to me…. She comes out and talks about her feelings…” Right side: Photo of Father kneeling while hugging his son holding a toy, smiling at the camera. Inner Right page: Caregivers’ Service Experience Types of Services Received . At intake, children received an average of 3 different system of care services . 93.2% of caregivers participated in the development of their child’s service plan Name of Service Intake 6 Months Name of Service: Assessment/Evaluation Intake: 98.0% 6 Months: 69.0% Name of Service: Transportation Intake: 58.0% 6 Months: 66.0% Name of Service: Case Management Intake: 43.0% 6 Months: 68.0% Name of Service: Informal Support Intake: 38.0% 6 Months: 44.0% Name of Service: Family Support Intake: 26.0% 6 Months: 53.0% Name of Service: Individual Therapy Intake: 6.0% 6 Months: 15.0% Name of Service: Family Therapy Intake: 4.0% 6 Months: 4.0% Name of Service: Crisis Stabilization Intake: 1.0% 6 Months: 1.0% Data collected using the Multi-Sector Service Contacts-Revised (MSSC-R). Caregiver report: N = 100. Caregivers Report Positively Caregivers Perspectives on Services % Reporting Positively 6 Months 12 Months Access to Services 6 Months: 85.4% 12 Months: 75.6% Social Connectedness 6 Months: 76.9% 12 Months: 76.9% Participation in Treatment 6 Months: 76.3% 12 Months: 81.6% Outcome 6 Months: 68.4% 12 Months: 71.1% Functioning 6 Months: 68.4% 12 Months: 73.7% Satisfaction with Services 6 Months: 67.5% 12 Months: 70.0% Data collected using the Youth Services Survey for Families (YSS-F) Caregiver Report. N = 39. Cultural and Linguistic Competence All families are asked if they would like free language assistance services when they first enter the program. Interpreters are used during New Family Orientation and service delivery. After 12 months, 94.9% of caregivers reported positively when asked about Project Kariñu’s cultural sensitivity in providing services. When asked, “How important is it that….,” caregivers responded at 6, 12, & 18 months: 6 Months 12 Months 18 Months You and your child have a service provider who understands the customs, practices, and traditions of your child’s racial/ethnic group? 6 Months: 76.4% 12 Months: 58.2% 18 Months: 72.7% The beliefs, traditions, and practices of your racial/ethnic group are included in service planning and provision? 6 Months: 61.8% 12 Months: 52.7% 18 Months: 60.0% The person you and your child have seen most often is of the same racial/ethnic group as your child? 6 Months: 32.7% 12 Months: 25.5% 18 Months: 41.8% Data collected using the Cultural Competence and Service Provision Questionnaire, Revised (CCSP-R) Caregiver Report: N = 55. Right side: Photo of Mother holding child holding toy car, smiling at the camera. Outer Left side: Family Support Activities Strong families are the foundation for positive outcomes for young children and Project Kariñu works to strengthen families and build resiliency through its Family Support Activities. Seventeen family support activities were conducted from October 2014 to September 2015. Four Bar Graphs: Number of Participants First Graph: Bar Graphs Legend: Orange: Peer Family Support Group Red: Play Port Play Date Blue: New Family Orientation Green: Parent Café Peer Family Support Group: 16 New Family Orientation: 59 Play Port Play Date: 61 Parent Café: 83 Parent Cafés strengthen families and develop parenting skills. During the Cafés, caregivers engage in conversations and learn from each other. Second Graph: Legend: Blue: Agree; Gray: Disagree I learned something that will help me as a parent Blue: 99% I plan to change something about my parenting Blue: 97% New Family Orientation is conducted monthly. Families meet with staff, complete initial screening questionnaires, and learn about the program and system of care approach. Third Graph: Legend: Blue: Strongly Agree; Sky Blue: Agree; Baby Blue: Somewhat Agree I understand how Kariñu can help my child & family Strongly Agree: 74% Agree: 21% Somewhat Agree: 5% The information was easy to understand Strongly Agree: 79% Agree: 16% Somewhat Agree: 5% Peer Family Support Groups allow families to get together informally to learn something new and connect with other caregivers. Fourth Graph: Legend: Blue: Strongly Agree; Sky Blue: Agree I felt comfortable sharing Strongly Agree: 92% Agree: 8% I learned something new Strongly Agree:92% Agree: 8% Collage of happy kids playing. Play Dates give caregivers “a break” from the stress of raising a child and create positive interactions through play. This event was able to provide my son with the opportunity to socialize with more children his age. I’m really excited to be here. I love spending time with my kids and enjoy watching them run around and have fun. And making friends is important too! Outside Center page:   If You’re Concerned About A Young Child Because Of: • Poor weight gain or slow growth • Problems sleeping • Problems being comforted or soothed • Excessive fears or fussiness • Delayed development Contact: Project Kariñu (671)478-5400 Department of Public Health and Social Services Terlaje Professional Building, 2nd Floor, Suite 208 194 Herman Cortez Avenue, Hagatna, Guam 96910 www.projectkarinu.org For More Information About the Evaluation Report Contact: Project Kariñu Evaluation Team University of Guam Center for Excellence in Developmental Disabilities Education, Research, and Service (Guam CEDDERS) House #12 Dean Circle, Mangilao, Guam 96923 (671) 735-2397/98/2618 Department of Public Health and Social Service Logo Project Kariñu Loving Our Babies Logo Guam CEDDERS logo This report was prepared by Bonnie Brandt, M.A. and Keith Villaluna, B.B.A., University of Guam Center for Excellence in Developmental Disabilities Education, Research, and Service (Guam CEDDERS). One hundred percent (100%) funding for this publication was provided by the Child Mental Health Initiative (CMHI) Cooperative Agreement 5U79SM059022-06 between the U.S. Department of Health and Human Services/Substance Abuse and Mental Health Services Administration/Center for Mental Health Services and the Guam Department of Public Health and Social Services. The University of Guam is an Equal Opportunity Employer and Provider.