DULCE

Creating family-centered, equitable access to critical supports


What We Work For

Developmental Understanding and Legal Collaboration for Everyone (DULCE) is transforming the way families experience healthcare. 

DULCE is an innovative intervention based in the pediatric care setting that proactively addresses social determinants of health, promotes the healthy development of infants, and provides support to their parents, all during the precious and critical first 6 months of life. DULCE does this by introducing a Family Specialist trained in child development, relational practice, and concrete support problem solving into the pediatric care team. Family Specialists attend well-child visits with medical providers and families. They get to know the families, provide peer support, and then work with the DULCE interdisciplinary team to connect families with resources and support. 

The DULCE interdisciplinary team is comprised of a Family Specialist, a medical provider, a legal partner, an early childhood representative, a mental health representative, a project lead, and a clinic administrator. Together, they can connect families to critical supports and reduce their stress, thus giving families more time and energy to bond with and care for their new child. Many conditions contribute to stress, including poverty, inadequate housing, and lack of adequate nutrition, all of which are more likely to impact families with low income, families of color, and immigrants. DULCE seeks to address these disparities by utilizing community health models, accelerating access to justice, and advocating for systems change, all based on families’ needs.

The DULCE model first began being replicated and evaluated in 2016 in five Early Childhood Learning and Innovation Network for Communities (EC-LINC) communities as a component of their local early childhood systems– and it is already expanding. If you are interested in learning more about DULCE, please click the tabs below or contact our experts. 

 

DULCE employs a strength-based approach to help parents navigate the challenges of caring for babies, raising healthy children, and advocating for what they need. We are transforming the way families experience the healthcare system, starting with their baby’s first routine medical visit. Families develop a relationship with a DULCE family specialist, who helps them navigate supports and creates the conditions for healthy development. By prioritizing parent-identified needs, connecting them to support, and building trusting relationships, parents get the support they need to raise healthy children and advocate for their well-being.

DULCE embodies a belief that all children and families should have the support they need for healthy development. The DULCE approach includes:

An existing community-based, early childhood organization that coordinates care which brings together early childhood, legal, and healthcare experts to connect families to complementary resources and support.

Well-trained, supervised Family Specialists. A critical part of the primary care team, Family Specialists are trained in Brazelton Touchpoints and the Newborn Behavioral Observations and provide direct support, fostering a trusting relationship with the medical provider and building parents’ confidence.

Partners who work together. They review cases weekly, problem-solve together, and ensure that families are connected to needed services.

A team that honors families’ needs and priorities. Parents know their families best. The team listens and works with parents on what their families need most.

Clinics are located in communities that can benefit most. We recognize that all families need support during the first six months of a child’s life, and work to provide equitable access to care.

The model was co-developed by Robert Sege, MD, Ph.D., now at Tufts Medical Center, and Samantha Morton, CEO, MLPB. It is grounded in the compelling findings from a randomized controlled trial (RCT) conducted at Boston Medical Center in 2010-13. DULCE has a statistically significant impact on enrolled children and families, as well as the clinics that serve them. Results from the RCT published in Pediatrics in 2015 found that DULCE resulted in:

  • Accelerated access to concrete supports. DULCE families secured supports for which they were eligible at roughly twice the pace of control families.
  • Better completion rates for well-child visits and immunizations.
  • Reduced use of emergency room care by DULCE families.

DULCE Outcomes

As DULCE expands to more sites, more families will be connected to the support they need for their children to get a healthy start.

Partners implementing and installing DULCE can access the partner portal for resources, materials and information about partner events and meetings.

Visit Partner Portal

Our Experts

Stephanie Doyle

Stephanie Doyle

Senior Associate
Contact:
She, Her, Hers
stephanie.doyle@cssp.org
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Azieb Ermias

Azieb Ermias

Program Manager, DULCE
Contact:
She, Her, Hers
azieb.ermias@cssp.org
SEE FULL PROFILE  
Amy Fine

Amy Fine

Senior Fellow
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Pasty Hampton

Patsy Hampton

Senior Associate and Director, EC-LINC
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