The Nurture® Program

The first three years of a child's life is a critical time in brain development that will support all future capacities. Decades of research has shown that the way that parents interact with their young children forms the foundation of their readiness for school and overall success in life. Historically, the U.S. has provided almost no public support for meeting the psychosocial needs of new parents and their babies. 

The Nurture® Program pairs moms of newborns with trained volunteer mentors to promote infant mental health and early language through an interactive text-messaging platform. We address four key building blocks of good parenting: secure attachment, which creates a strong sense of security and self-confidence; parent resilience, which determines a mom’s ability to manage maternal stress; parenting knowledge of accurate information and referral resources; and, child cognition. The Nurture® Program provides a highly cost-efficient and easily scalable model that also offers a unique opportunity to volunteer in a virtual environment.

Parents unquestionably are the most important people in young children's lives. Decades of research has shown that how parents interact with their young children forms the foundation of their readiness for school and overall success in life. Parents talking and reading to their babies, providing guided play, and praising effort are key ingredients to children's emotional regulation, which better predicts a healthy and successful life.

At the same time, becoming a parent is a jolting transition, which can often lead to increased maternal stress and not infrequently to perinatal depression and/or anxiety.

Historically, the U.S. has provided almost no public support for meeting the psychosocial needs of new parents. This is a missed opportunity given that there are structural changes in new parents’ brains that make them very open to change. Our intervention takes aim at reducing parent stress and at improving parent-child attachment and language activities.

The Nurture® Program’s focus is on moms of newborns along with their babies in western Pennsylvania. We are currently enrolling moms in five of the twelve hospitals in the region, and plan to expand to the remaining hospitals. Over 20,000 births a year occur in the region’s birthing centers, and we plan to be contacting all moms in the twelve hospitals by the end of 2023.

Our supervisors visit birthing centers and meet briefly with every mom on the visit day to explain the program. We do not select moms for the program based on any qualifying criteria, but rather invite all moms that we meet with to enroll. Moms decide whether or not to participate. For those moms who are interested, the supervisor enrolls her in the program and assigns her to a mentor who then reaches out to the mom following discharge to begin a dialogue.

Our community provides home visiting programs for parents to support the development of their new child. Because of cost, these programs are generally targeted only to the most at-risk parents. Many, perhaps lower-risk parents, who need help with parenting skills are not being served. For these parents, finding evidence-based information (such as how babies eat, sleep, play, learn and grow) at the exact time that it is needed can be challenging. Our program meets the needs of the moms by providing real-time support and information at the time they are needed.

Our primary mission is to provide an innovative program (Nurture® Program) that transforms how parents promote infant mental health (i.e., the healthy social emotional development of children between the ages of 0-3 years) and early language. The Nurture® Program pairs moms of newborns with trained volunteer mentors who provide parenting support and information through an interactive text-messaging platform.

Helping children grow up to be happy, healthy, and successful in life is a function of good parenting, particularly during a child’s early years. This is a critical time in brain development that will support all future capacities including intellectual abilities as well as emotional and psychological habits. Key building blocks of good parenting during these formative years are: (1) secure attachment, which creates a strong sense of security and deep-seated self-confidence; (2) parent resilience, which determines a mom’s ability to manage maternal stress; (3) parenting knowledge of accurate information and referral resources; and, (4) child cognition.

The Nurture® Program addresses these four key building blocks during a child’s first three years. Secure attachment is promoted by encouraging sensitive caregiving along with positive, serve-and-return interactions between mom and child (e.g., talking, reading, playing). Parent resilience along with parenting knowledge are supported by relieving maternal stress through a stable, positive mentoring relationship; providing evidence-based information at the time it is needed; and, making needed referrals. Child cognition is advanced by promoting cognitive as well as social emotional development including talking and reading activities.

All volunteer mentors are trained and supervised by managers who have a background in early child development and family support. Mentor training includes early child development along with procedures for creating a mentor/mom relationship that is characterized by trust and reciprocity. This type of relationship constitutes the required active ingredient of effective interventions and can be formed in a virtual environment. Mentor supervision is data-driven in that mentor evaluations are supported through a software tool that efficiently and consistently reports evaluation results to managers as a means of guiding ongoing mentor training and providing individual mentor feedback.

The combination of three components of the Nurture® Program make it innovative:

• Providing mentoring interventions through interactive text messaging;
• Focusing on building relationships verses prescriptive messaging; and,
• Using an interactive text-messaging software platform to:
  • disseminate information to moms in response to their questions; and,
  • drive a cost-efficient and scalable model.

The Nurture® Program relies on software technology to provide a highly cost-efficient model. Equally important, the technology makes the Nurture® Program easily scalable as opposed to typical social service programs. We couple volunteer mentors with a newly developed software tool that allows mentors to easily interact and dialogue with parents on an ongoing basis through cell phone texting. Engaging parents through cell phones helps them quickly address their immediate needs, and offers ease of access in a manner more acceptable to this generation of young parents.

The software features that drive a cost-efficient and scalable program include:

• A secure, web-based application that mentors access from their home or place of work;
• Built-in prompts that remind mentors to explore age-specific child development issues;
• Domains (e.g., sleeping, feeding, interacting) that are assigned to text messages and can be sorted to help manage communications;
• Evidence-based, non-proprietary resource information that mentors access through the software to provide mobile-friendly answers to parents’ information needs; and,
• Supervision that is supported by allowing managers to review mentor communications.

We can consider the entire spectrum of activities involving good parenting and healthy child development as a as a series of linkages or chain of events, where one link leads to another, which leads to another, and so on. Inputs describe the activities and interventions of a product or service, outputs provide data that describes who is affected and what is produced as a result of a product or service, outcomes (short-term) include knowledge and attitudes, as well as behaviors and activities (intermediate) of those who are affected, and long-term outcomes describe the humanitarian value.

Our inputs include the texting interventions, and serve as an initial link in the chain. Our outputs demonstrate that mentors and moms text an average of three time a week; that information is about attachment (50%), maternal stress (30%), and developmental milestones (20%); and, that referrals are made often for healthcare and parenting support. Survey results of moms (short-term and intermediate outcomes) report that the vast majority of moms interact more with their children; feel more confident and less stressed as a parent; have a positive relationship with their mentors; receive timely information and referrals; and, believe the program improved or will improve their child’s ability to learn in preschool. Based on the theory of change, it logically follows that desired longer-term outcomes are more likely to be achieved such as school readiness (including good self-regulation, social skills, and executive function skills) and living a healthy, happy and successful life.

We define our initial market as the twelve birthing hospitals in western Pennsylvania, and we are currently serving over 600 moms who have enrolled from five of the local hospitals. Our growth plans for the initial market include expanding the number of enrollment days at our current hospitals, and expanding the Nurture® program to the remaining seven hospitals in our market. Over 20,000 births a year occur in the initial market, and we project that we will be serving 1,850 moms by mid-2020. The number of moms served will continue to grow until it levels off to a steady number of approximately 6,000 moms by the end of 2023.

Our five-year growth plans include two components: (1) growing and managing the program in western Pennsylvania; and, (2) licensing the program to organizations in other regions of the country. NurturePA defines its initial market as the twelve birthing hospitals in western Pennsylvania. We are currently enrolling moms in five of these hospitals; plan to increase to seven hospitals within the next year; and, plan to be enrolling moms in all twelve hospitals by the end of 2023.

The goal of the initial market is to demonstrate a viable, sustainable Nurture® Program in a defined geographical region (i.e., western Pennsylvania). To grow the program beyond the initial market, we plan to license it to interested organizations. Over the next one to two years, we will be defining the legal and protective issues associated with a licensing arrangement that allows a licensee to have access to our proprietary knowledge, software tool, policies and procedures, and registered trademark in order to provide the Nurture® Program. We will also be defining the licensing process along with the fees for the initial start-up, training, and annual licensing.

Because the Nurture® Program combines its software platform with volunteer mentors, it is financially highly cost-efficient and technically easily scalable. Our primary challenge is to demonstrate a sustainable program in our initial market. To convert the current program that is funded primarily by local foundations into a long-term sustainable program, we plan to demonstrate its benefits to potential revenue sources including the counties in western Pennsylvania, local healthcare systems, and corporate sponsors that might jointly provide ongoing funding.

We currently have a contract with Allegheny County DHS, and intend to expand their support by documenting our impact on moms and their babies by measuring outputs and short-term survey outcomes, as well as serving as a gateway for high-risk moms to county services including home visiting programs. For healthcare systems, we will record medical referrals by type and volume for each of the health systems to document our impact on their services.

A growing number of corporations are promoting volunteerism among their employees. Often they have been lending out their skilled employees to nonprofit organizations to do volunteer work on company time and cost. For many young job seekers, the opportunity to provide volunteer services is a strong selling point, and corporations are focusing on volunteerism to attract and retain the millennials who want to work for a company that contributes to society. The Nurture® Program offers a unique opportunity for employees to volunteer for brief periods of time from their work setting without impacting their productivity, or from home without interrupting their family time, and at the same time have a strong sense fulfillment and contributing to society. As we form positive relationships with corporations through recruiting their employees as volunteer mentors, we can explore corporations' interest in helping fund the Nurture® Program through their budgets that might support other types of volunteer activities.

Paid team members include a full-time Director of Operations, a part-time (25 hours/week) Director of Communications, two part-time (20 hours/week) Managers of Operations, three part-time (20 hours/week) Operation Supervisors, and two part-time (15 hours/week) programmers. Volunteers include 80 mentors along with the organization’s president, treasurer, chief information officer, and director of volunteer recruitment.

Our team consists of individuals with skills and backgrounds in (1) successful start-up businesses with MBA degrees; (2) early child development with graduate degrees in related fields; and, (3) software engineering with experience in developing platforms. We have successfully operated the Nurture® Program at local birthing centers since mid-2014. During that time, we have contacted over 3,700 moms during their stay at birthing centers; enrolled approximately 50% of contacted moms; maintained and trained 80 volunteer mentors; and, processed over 140,000 text messages of which 40% were sent by parents. The text messages addressed maternal and child health, feeding, sleeping, crying, and activities that promote attachment. We have made 1,372 referrals for breastfeeding (30%); family support and parenting (27%); and, maternal and child health (21%).

We have found that our program is well accepted by both parents and hospital staff; that our use of technology drives a very cost efficient and scalable program; and, that volunteer mentors find their involvement highly rewarding.

We have networked with organizations that share our interest in infant mental health and early literacy. The networking has resulted in forming collaborative arrangements with United Way’s PA211, Carnegie Library of Pittsburgh, Cribs for Kids, Project LAUNCH, Jefferson Community Collaborative, and Allegheny LINK. We have been invited by Allegheny County Health Department to participate in their Plan for a Healthier Allegheny, and our Director of Operations is co-chair of the focus group on maternal and child health. In addition, we are partnering with the Pennsylvania Organization for Women in Early Recovery (POWER) to provide a collaborative approach to mentoring moms in recovery that helps relieve the stresses of parenting that might interfere with a successful recovery as well as supporting parenting skills that promote healthy child development.

NurturePA is a charitable, 501(c)(3), non-profit organization with the primary mission of providing an innovative program (The Nurture® program) that transforms how parents promote infant mental health (i.e., the healthy social emotional development of children between the ages of 0-3 years) and early literacy. Our primary focus is to form strong, supportive relationships between moms of newborns and trained volunteer mentors. The Nurture® Program relies on software technology to provide a highly cost-efficient and scalable model. We couple volunteer mentors with the newly developed software tool that allows mentors to easily interact and dialogue with parents on an ongoing basis through cell phone texting. To convert the program from short-term funding by foundations to a long-term sustainable model, we plan to demonstrate its benefits to potential revenue sources including the counties in western Pennsylvania, local healthcare systems, and corporate sponsors as well as licensing the program to organizations in other regions of the country.

As noted earlier, we currently have a contract with Allegheny County DHS, and intend to expand their support by documenting our impact on moms and their babies by measuring outputs and short-term survey outcomes, as well as serving as a gateway for high-risk moms to county services including home visiting programs. For healthcare systems, we will record medical referrals by type and volume for each of the health systems to document our impact on their services. 

A growing number of corporations are promoting volunteerism among their employees. Often they have been lending out their skilled employees to nonprofit organizations to do volunteer work on company time and cost. For many young job seekers, the opportunity to provide volunteer services is a strong selling point, and corporations are focusing on volunteerism to attract and retain the millennials who want to work for a company that contributes to society. The Nurture® Program offers a unique opportunity for employees to volunteer for brief periods of time from their work setting without impacting their productivity, or from home without interrupting their family time, and at the same time have a strong sense fulfillment and contributing to society. As we form positive relationships with corporations through recruiting their employees as volunteer mentors, we can explore corporations' interest in helping fund the Nurture® Program through their budgets that might support other types of volunteer activities.

Because the Nurture® Program combines its software platform with volunteer mentors, it is financially highly cost-efficient and technically easily scalable. Our primary challenge, that Solve might help us overcome, is to demonstrate a sustainable program in our initial market. To convert the current program that is funded primarily by local foundations into a long-term sustainable program, we plan to demonstrate its value to potential revenue sources including the counties in western Pennsylvania and local healthcare systems. For counties, we will serve as a gateway for high-risk moms to county services including home visiting programs. For healthcare systems, we will record medical referrals by type and volume to document our impact on their services.

In addition, a growing number of corporations are promoting volunteerism among their employees. The Nurture® Program offers a unique opportunity for employees to volunteer for brief periods of time from their work setting without impacting their productivity, or from home without interrupting their family time, and at the same time have a strong sense fulfillment and contributing to society. As we form positive relationships with corporations through recruiting their employees as volunteer mentors, we can explore corporations' interest in helping fund the Nurture® Program through their budgets that might support other types of volunteer activities.