Making the case for investments to promote child health: A case study of Nemours Health & Prevention Services (NHPS)

Background: Nemours is a comprehensive child health system expanding the traditional role of primary care providers though: implementing a population-oriented approach grounded in the socio-ecological model that is multi-faceted, multi-sector and involves multiple caregivers as change agents; engaging community-based coalitions that bring the multi-sector integrated approach together in a place-based strategy; systems or environmental changes including professional practice and policy improvements; knowledge dissemination system; and social marketing. The initial areas of emphasis are childhood obesity prevention and emotional and behavioral health.

Methods: The population-level focus reflects an expansion of the traditional medical model to a multidimensional view of health. NHPS' model posits that the greatest opportunity for significant system improvement is through policy and practice changes, balanced to reach the most children with the most sustainable impact and the most cost-effective use of resources. The theory of change used by NHPS articulates that these change concepts are a precursor to obtaining positive impacts on children's health and behavior change. Nemours is also investing in research to analyze the cost-benefit impact of child health on adult health and economic potential, as well as research in the area of developing and implementing new methods for using evidence to guide policy related to child health promotion within the healthcare sector.

Results: Multi-faceted public health approaches are most effective and have the broadest impact on children's health compared to individualized medical interventions. Appropriate evaluation methods must be in place to gauge the success of these changes.