Innovative Strategies for Promoting Developmental Health in Rural Alaska

Approximately 13,000 people live in Alaska’s Kodiak Island Borough, which is comprised of the City of Kodiak and six surrounding villages. The only way to get to Kodiak or travel between the different villages is by boat or plane. In this remote island community, it can be difficult for families to connect with public health and community resources, especially during the early years of life when children are developing rapidly.

“The villages have elementary schools, but they don’t have access to pre-school,” explains Cassie Keplinger, the family services coordinator for the Kodiak Area Native Association (KANA), a tribal organization that provides health care and social services to Alaska Natives and the community. “We have Early Intervention services, but it’s not always easy to identify children to get them enrolled, especially for families outside of Kodiak city. And even if you’re living in the city, it’s still a remote area so there are a number of barriers—weather, transportation, etc.—to reaching families with young children.”

Kodiak is one of 28 place-based communities partnering with 12 state teams on the NICHQ-led Early Childhood Comprehensive Systems Collaborative Improvement and Innovation Network (ECCS CoIIN). This five-year grant, funded through the Health Resources and Services Administration Maternal and Child Health Bureau, seeks to improve early childhood systems so that all children can achieve their optimal health.

“A comprehensive early childhood system is incredibly important in all states, but uniquely so in states with rural communities like Kodiak because those families are isolated from supports,” says NICHQ Project Director Loraine Swanson, MPH. “By partnering with community-based organizations, like the Kodiak Native Association, Alaska can develop sustainable solutions that respond to real community needs, respect and support local culture, and build off existing infrastructure.”

Over the past four years, Kodiak has tapped innovative opportunities to connect the families in their community with resources and services that support developmental health. Here, Keplinger, who leads Kodiak’s ECCS CoIIN efforts, shares three key strategies that contribute to their success.

Developing an early childhood coalition

The Kodiak Early Childhood Coalition is comprised of nearly 30 local organizations committed to supporting children’s developmental health. Partners on the coalition include local preschools, Head Start, the Kodiak Island Housing Association, Kodiak Childcare, the KANA Infant Learning Program, Kodiak Island Borough School District and Providence Pediatric Therapy, to name just a few. By bringing together a diverse set of stakeholders from multiple sectors, Kodiak has created a comprehensive network of community supports. Together, this network helps families access resources that address the many social determinants affecting children’s developmental health—whether that’s safe housing, affordable childcare, or access to Early Intervention services.

The coalition began as part of an earlier early childhood-focused grant and continued to meet semi-regularly once the grant ended. “ECCS CoIIN really brought the coalition back to life as an ongoing work group that drives a lot of activities,” says Keplinger. “We’re developing a five-year work plan around supporting developmental health in our communities, and we’re leveraging a collective impact approach to get us there.”

During coalition meetings, members plan coalition-sponsored events and share any new resources or activities they’ve developed, so that everyone knows what community resources exist. They also consider new opportunities to connect families with wrap-around services. For example, a new partnership with Kodiak’s Women Infants and Children (WIC) program may lead to opportunities to start sharing developmental health resources with families during prenatal care.

Host community events

The coalition has launched several large community events that serve as one-stop shops for early childhood support. During the events, families learn about early childhood development—why it is important and how families can support it; receive handouts on activities that support developmental health; go through the Ages and Stages Questionnaire (ASQ), a screening that assesses developmental milestones; and, when needed, connect with early childhood services like Early Intervention.  

• The Kodiak Annual Children’s Fair: One of Kodiak’s largest events, the fair brings together more than 30 organizations and programs and over 200 members of the community. Along with a host of kid-friendly activities, the fair provides trainings for childcare providers, parenting classes, and an opportunity to connect families with Kodiak’s early childhood programs.
• Kodiak Community Baby Showers: Community baby showers are an annual event, generally held in January or February, where the Kodiak community comes together to celebrate all the babies born in the previous year. During the shower, families can complete the ASQ and receive fun door prizes in return. KANA’s Infant Learning Program staff go through the screening results with families and, when necessary, connect them with a developmental specialist who can immediately schedule a follow-up evaluation.
• Books, Blocks and Balls events: these interactive community screening events have multiple activity stations where children can engage in developmentally appropriate play—with books, blocks, and balls—while parents complete the ASQ.

“All of these events have been really popular in Kodiak; they’ve brought the community together and connected families with a network of supports,” says Keplinger. “We try to plan them during the winter because it’s dark and cold and families really love the opportunity to get out of the house and do something together.”

Meet families where they are

The large community events reach a majority of families, but not everyone can attend since the events are located in Kodiak City. “It’s really important to meet families where they are, which is why we also host smaller events and activities that target specific populations,” says Keplinger.

Twice a year, KANA partners with each Alaska Native village school and provide informal “Lunch and Learns” where families participate in a fun developmentally appropriate activity and take the ASQ. If a child has a developmental delay, then KANA’s Infant Learning Program schedules an evaluation followed by monthly check-ins in the village. “We’re really focused on building trust in the villages, and bringing services right to them goes along way,” says Keplinger

Recognizing that transportation is a significant barrier for families with less resources, KANA also hosts events in community housing development family centers and in nearby parks. Recently, they’ve also started partnering with the local military base to better support military families around early childhood development. A Books, Blocks and Balls event was highly attended, and they hope to host monthly events on base in future. 

“For us, creating a coordinated system relies on flexibility,” says Keplinger. “We’re a rural community with a diverse population in a really unique location, and what works for one population or in one place might not work in another. By being flexible and responsive to different needs, we can help all families get the supports they need to thrive.”