Goal 1

Promote general awareness within the community about the issue of early childhood development and parent engagement.

In order to address early childhood quality of life in Waco, it is imperative that all relevant stakeholders are aware of their role in improving children’s lives. This goal accomplishes that through connecting, communicating and coordinating the current early childhood professionals and resources to galvanize our community efforts and strengthen the overall work.

SmartBabies Awareness Meetings

Early Childhood Quality of Life Partnership

Waco Foundation engages in new partnership with Healthy Babies are Worth the Wait® to improve Early Childhood Quality of Life in our community. 

  • The infant death rate in McLennan County is 29.5% higher than the rate in Texas*.  The rate among African-American women is nearly three times the rate of non-Hispanic whites and double that of Hispanic women. Provided this information the, Texas Department of State Health Services (DSHS) granted the McLennan County Public Health District $200,000, which runs till August 2013, to implement the March of Dimes’: Healthy Babies are Worth the Wait. Healthy Babies are Worth the Wait® (HBWW) is an intervention to reduce infant mortality in two zip codes (76704 and 76706). The HBWW implementation included targeted components that reached multiple populations in the community: women of childbearing age, healthcare providers, and the community at large. SmartBabies continues to be actively involved as a partner in this collaboration that also includes the Healthy Babies Coalition, Providence Healthcare Network, Hillcrest Baptist Medical Center, McLennan County Public Health District, the March of Dimes and many other organizations noted below.

Healthy Babies are Worth the Wait 5 P's:

1. Partnership & Collaboration

Coalition Members include:

  • Trinity AME Church
  • Prairie View A&M Cooperative Extension Program
  • Waco Center for Women's Health
  • Superior Health Plan
  • Head Start
  • Texas Health Steps

2. Patient Support

  • As a part of the HBWW work, the Healthy Babies Coalition hosts an 8-week class for women of childbearing ages in various churches, housing complexes, and health care facilities. The class is centered around the Becoming a Mom curriculum created by March of Dimes and is proven to improve outcomes from moms and children.

3. Provider Support

  • An integral part of the HBWW model is educating healthcare providers on the most recent evidence-based preterm birth prevention information. One component of the Provider Initiative program is Think 39 – Quality Improvement Service Package, a hard stop policy to prevent elective deliveries prior to 39 weeks gestation in both local hospitals in Waco.

4. Public Engagement

  • In addition to educating women of childbearing age through patient support, it was important that the larger community of Waco and McLennan County be concerned about the outcomes of preterm births.  To reach an even larger number of McLennan County residents after the launch of the program, the HBC implemented a mass media campaign. The campaign includes 3 outdoor billboards in high risk zip codes, 2 digital billboards, cinema advertising, 6 bus benches, 8 bus windows, and television and radio commercials. The message delivered through the campaign emphasizes the importance of carrying a baby to full term.  Feedback from community members has revealed that the messages spread throughout target communities have resonated with many.

5. Progress Measurement

  • The fifth P uses current data sources to measure the progress of community awareness, provider and patient knowledge attitudes and beliefs, as well as perinatal outcomes to continue to ensure that progress is being made and that all the P’s are having an impact on  birth outcomes. To date, local physicians have been surveyed, as well as the general community to determine the community knowledge of preterm births. 

Making an Impact

As of November 2013, we are pleased to share some of the results from the initial implementation of Healthy Babies are Worth the Wait.

Becoming a Mom Participant Survey

Ninety- four (94) pretest and 86 post-test surveys were collected from the participants in the Becoming a Mom classes. The majority of respondents (47%) were African American women of reproductive age, which was the target population for this intervention. The survey measured knowledge of preterm risk factors, and attitudes toward how serious a problem preterm birth, low weight birth and infant mortality is in the community. Significant key changes in participants include:

  • Increase in attitude toward how serious an issue preterm birth is in the community (23% increase)
  • Increase in attitude toward how serious a problem preterm birth (23% increase), low birth weight (21% increase), and infant mortality (17% increase) are
  • Increase in knowledge of whether it is a good idea to schedule delivery at 35-36 weeks for convenience (20% increase)
  • Increase in knowledge that a cesarean delivery is not usually safer than a vaginal delivery (15% increase)

The survey analyses strongly suggest that HBWW had a positive impact on participant knowledge and attitudes.

Health Care Provider Survey

The aim of the survey was to assess provider knowledge, attitudes and behaviors relevant to prematurity, and awareness of HBWW. The survey measured knowledge of preterm risk factors, attitude towards progesterone therapy, beliefs on smoking during pregnancy, concern toward elective induction and increased preterm birth rates, and awareness of HBWW. Significant key changes among providers include:

  • Increase in opinion that elective inductive guideline is 39 weeks
  • Awareness of HBWW (45% increase)
  • HBWW impact (26% increase in “Effective” responses)

The survey analyses suggest that HBWW had a positive impact on consumer knowledge and attitudes and on providers’ provision of messages and information to patients about services and behaviors that could help to reduce preterm birth, in the intervention site catchment areas.

For more information, please visit:

SmartBabies Bulletin

As the initiative continues to forge ahead in improving children’s quality of life, the SmartBabies Bulletin keeps all stakeholders informed. Please check back periodically for updates. To sign up or provide information for the newsletter, please contact Ashley Weaver, Director of the SmartBabies Initiative via email or at 254.754.3404. 

Timeline of Waco Maternal-Child Health & Well Being Developments

Community investment in early childhood did not begin with this Initiative; for more than four decades Waco has given time and resources to improve life for children in our community. It is time to end poverty by targeting the root cause. It is not a matter of no one caring; the history of investment in our community makes that clear. Community investment in early childhood does not begin with this initiative; for more than four decades Waco has given time and resources to improve life for children in our community. Let us learn from our trials and triumphs over the decades to improve the quality of life for children 0-3 years old.

Year Event
1967 EOAC Head Start Begins
1970 Waco-McLennan County Family Practice Residency Program officially began and the Community Health Clinic opens
1982 Early Childhood Intervention (ECI) was funded by the Texas Legislature in 1980 and two years later the Klaras Children’s Center ECI received one of the first grants serving children from birth to 3 with developmental delays and disabilities
1985 Parents as Teachers program launches in WISD
1988 Youth Connection began helping young people overcome obstacles and influences that place them at risk
1990 Neonatal Intensive Care Unit was opened in September of 1990 under the leadership of Dr. Darrell Wheeler, M.D.
1991 Texas Workforce rolled out Texas Rising Star
1993 The Bond Program: A proposal to enhance prenatal care in McLennan County
1994 Cooper Foundation funded a 3-year grant for $258,375 to implement an intensive pre and post natal program which was later called First Steps
Mid 1990's Waco National Association for the Education of Young Children
1996 McLennan County Childcare Association (MCCA)
1997 Childcare Collaboration Meeting, convened by Rapoport Foundation

Bernard and Audre Rapoport Foundation awarded two grants that totaled over $1 million to fund the birth through three Parents as Teachers Programs and five full-day prekindergarten sites
1998 Jumpstart Classrooms – Head Start & WISD Collaboration within schools
1999 Early Childhood Visioning @ Waco Convention Center - Rapoport Foundation effort Smart Start Coalition is formed from MCCA
2002 Start of Early Head Start
2006 Inaugural Waco Celebration of the Week of the Young Child
2007 Tom & Lou Collins Fund for Early Childhood Development was created as a tribute to Tom Collins as the Waco Foundation Executive Director. Texas School Ready Program implemented in Waco
2008 First Greater Waco Alliance Annual Education Summit

Touchpoints Coalition Formed

Waco Foundation funded $125,000 towards Early Childhood & Quality of Life Study

Second Greater Waco Alliance Annual Education Summit: Preliminary Quality of Life Report presented

Posting of Early Childhood Quality of Life Report on KWBU website

Resurgence of Annual ChildOne Banquet & Waco Foundation funding of the Hatch iSmart Computer to a childcare facility

First ChildOne Calendar - highlighting childcare resources in the Waco Community

2010 Third Greater Waco Alliance Annual Education Summit: Quality of Life breakout session – community next steps

Waco Foundation funded $45,000 for Talitha Koum Brain Development Symposium

Waco Foundation Board of Trustees elects to hire Director of Early Childhood to follow-up on coordination of early childhood efforts.

Public Health District receives a $200,000 grant to implement Healthy Babies are Worth the Wait

Waco is famous for the unprecedented, unmatched way we—at all levels of civic and community engagement—come together to achieve common goals. Increasing the quality of life for our children will be no less of a challenge than the hurdles our community has overcome in the past, and no less critical. Our community desires a workforce that is sustainable and a school system in which children come to school ready to learn. We as a community are capable of making these possibilities a reality—and starting with the youngest members of our community makes it possible.

This timeline is a compilation of dates based on records, meeting notes and the oral history of early childhood stakeholders throughout our community. It will continually be updated as more information becomes available. Please contact Ashley Weaver via email for edits and/or additions.

Early Childhood Quality of Life Report

The quality of life for children 0-5 years old in McLennan County is 41.67% out of 100%. This information was gathered as a result of a study completed in January 2009, prompted when the Waco Foundation commissioned the Texas Early Childhood Education Coalition (TECEC) in Austin to gather and evaluate information regarding the needs of children in McLennan County. A "Quality of Life" (QLI) index was created to provide a score for every zip code, which allows leaders to implement solutions strategically within the areas that were identified as having the highest need, while focusing on the 12 factors that influence child outcomes. This report is helping local health care, education, and child care institutions plan for the future.

McLennan County Quality of Life

The study revealed a number of striking findings:

  • Overall QLI Score: McLennan County has an overall quality of life score of 42% out of a 100 point scale, using a weighted ranking of 12 risk factors most closely linked to a child’s health and educational development.
  • QLI Comparison: A 57% disparity exists between the lowest and highest county zip codes on the Early Childhood Quality of Life Index (QLI).
  • QLI and Teen Pregnancy: A high teen pregnancy rate is one of the greatest barriers to quality of life for young children. In 2007, over 400 teens living in the lowest QLI zip codes gave birth. Teen parents have a much higher likelihood of poor prenatal care which leads to low infant birth weights and high infant mortality rates. Should 400 teens continue to get pregnant annually, Waco will struggle to significantly reduce poverty and see better educational outcomes in the future.
  • Quality Childcare and Parent Engagement: Efforts to improve early childhood quality of life must focus on parents, particularly those expecting and with very young children. McLennan County has 37,757 children below the age of eleven and 12,311 child care slots available (9,683 child care, 953 Head Start and 1,675 Pre-K). Having quality child care, while important, cannot be the only method of care improvement. Because most children are in the care of parents, relatives or friends, it is vital that efforts are focused on communicating a child’s educational and developmental needs to this population.

Concentrating Our Focus

The study also provided encouraging news:

  • Focus on Zip Codes: McLennan County can concentrate its efforts in the zip codes that will result in the most drastic improvements for a child’s development and for the community.
  • Focus on Prenatal Care: Approximately 300 women in the lowest QLI zip codes do not receive adequate prenatal care. Efforts can be focused on increasing access to quality and affordable prenatal care, which would drastically improve outcomes for young children in these areas.
  • Focus on Early Childhood: Because early childhood education can be both inexpensive and highly rewarding, allocating relatively few resources to early childhood education yields significant results.
We encourage organizations, service agencies, work groups, and others to use the full report or elements of it to apply for grants, use the data for strategic planning, to improve program focus or to advocate on behalf of the populations you serve. For information on how others have used the report to enhance their work, please contact Ashley Weaver at aweaver@wacofoundation.org.  
If you would like to set up a meeting to learn more about SmartBabies, please contact Ashley Weaver, Director of the SmartBabies Initiative, at 254.754.3404 or email.

Phone: 254-754-3404
Fax: 254-753-2887


1227 N. Valley Mills Drive
Suite 235
Waco, TX 76710

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