Family-Centered Support Services Make Strides, But Institutional Change is Elusive

From 1992 to 1997, staff at Dartmouth-Hitchcock Medical Center planned and implemented a comprehensive, coordinated service system to address the medical and social needs of chronically ill children and their families in New Hampshire.

Researchers from Harvard University School of Public Health evaluated the program from 1994 to 1997.

Key Results

  • Project staff planned and implemented New Hampshire Partners in Health, a comprehensive, coordinated service system addressing the medical and social needs of chronically ill children and their families in the New Hampshire communities of Manchester, Laconia, Littleton, Keene and Dover.

  • Project staff created two initiatives to extend family support throughout the communities:

    • Through the School Partners initiative, nurses and educators at 33 schools received training to develop family-centered health care plans for these children.
    • The Office Partners initiative aimed at introducing new approaches to the management of chronic illness in primary care physician practices.
  • Project staff helped establish the Governor's Advisory Council for Children and Adolescents with Chronic Health Conditions to enlist state support for the concept of system-wide coordinated health care. The council became a line item in the New Hampshire state budget.

  • During the four-year period funded by RWJF, New Hampshire Partners in Health initiated 914 family support service contacts with over 600 families of chronically ill children in the state.

Evaluation Findings

  • Evaluators found that the project had succeeded in developing community-based support services for children with special needs and their families, but was less successful at changing school policies and the way health care was delivered to chronically ill children in medical practices.