Creating change in policy and practice at the community, state, and national level through comprehensive system building

There are ongoing efforts to promote comprehensive, cross-sector early childhood system building at the community, state, and national level. These efforts bring together representatives from different sectors including health, education, and social services to plan and implement program and policy changes to better address the needs of young children and their families. These initiatives draw heavily on a public health perspective and agencies with a public health focus have played a lead role in developing and leading them. Drawing on interviews with state and community leaders and experience at the national level, this presentation describes the process by which these efforts have been able to produce change in policy and practice. The presentation will show how interaction between the community, state, and national levels has played a critical role in how this work has evolved and will describe the state and community-level strategies that appear to be most effective in creating a climate of innovation. Challenges and opportunities for future development will also be described. Finally the presentation will: discuss the applicability of this framework to the development of comprehensive approaches in other policy arenas such as chronic disease prevention and treatment, youth development, services to veterans and their families, and services to the elderly and chronically ill; and describe why public health professionals are uniquely suited to play a lead role in these efforts.