Smart Start North Carolina

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Decision Makers
Retired Strategy

Retired strategies are no longer updated.

Date last updated

Smart Start is North Carolina’s statewide, comprehensive early childhood initiative. This public/private partnership provides access to high quality educational child care, along with health and family support services. The Smart Start model allows communities to determine and plan how to best serve the needs of young children and families locally1.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased school readiness

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased vaccination

  • Increased access to health care

  • Increased access to child care

  • Improved child care quality

What does the research say about effectiveness?

There is some evidence that Smart Start improves school readiness, especially for disadvantaged children1, 2. Additional evidence is needed to confirm effects.

Children from low income families who attend Smart Start centers realize greater gains in school readiness (e.g., cognitive, language, social, and motor skills) than peers who attend other day care centers. Children from higher income families appear to receive equal benefit from participation in Smart Start or other child care centers. Overall, children who attend Smart Start centers appear better prepared for kindergarten than children who do not participate in child care outside the home1. Smart Start participation is also associated with improved 3rd grade test scores in reading and math3.

Through Smart Start’s health services, participating children are more likely to receive a DTP vaccination and to have a regular source of care than non-participants4. Smart Start participation also appears to reduce the likelihood of special education placement in 3rd grade, which is associated with significant cost savings for the state5.

Research suggests that Smart Start partnerships work best when communities assess their baseline needs and develop plans locally, but set goals that can be evaluated by both communities and state officials. Communities can expect a multi-year collaborative process before achieving measurable outcomes6. The quality of child care provided at Smart Start centers appears to improve over time, especially when on-going quality improvement efforts are used. Centers with high quality care are associated with greater improvements in children’s school readiness than centers with lower quality care7

How could this strategy impact health disparities? This strategy is rated likely to decrease disparities.
Implementation Examples

Smart Start was created in 1993. The program currently operates in all 100 North Carolina counties through the North Carolina Partnership for Children, with the support of 75 local partnerships8. State legislation has authorized and supported the adoption and expansion of Smart Start over time9

Implementation Resources

Smart Start - Smart Start & The North Carolina Partnership for Children, Inc.

UNC-FPG - Bernier K, Boggs V, Bordeaux B, et al. North Carolina Smart Start evaluation notebook. Frank Porter Graham (FPG) Child Development Institute, University of North Carolina at Chapel Hill; 2002.

Footnotes

* Journal subscription may be required for access.

1 PPN - Promising Practices Network (PPN). On children, families and communities.

2 UNC-FPG - Bernier K, Boggs V, Bordeaux B, et al. North Carolina Smart Start evaluation notebook. Frank Porter Graham (FPG) Child Development Institute, University of North Carolina at Chapel Hill; 2002.

3 Ladd 2014 - Ladd HF, Muschkin CG, Dodge KA. From birth to school: Early childhood initiatives and third-grade outcomes in North Carolina. Journal of Policy Analysis and Management. 2014;33(1):162–187.

4 Kropp 2001 - Kropp N, Kotch J, Harris S, UNC-FPG Smart Start Evaluation Team. The effect of Smart Start health interventions on children’s health and access to care. Chapel Hill: Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill; 2001.

5 Muschkin 2015 - Muschkin CG, Ladd HF, Dodge KA. Impact of North Carolina’s early childhood initiatives on special education placements in third grade. Educational Evaluation and Policy Analysis. 2015;37(4):478–500.

6 Kroll 2000 - Kroll C, Rivest M. Sharing the stories: Lessons learned from 5 years of Smart Start. Raleigh: Early Childhood Initiatives in North Carolina; 2000.

7 UNC-Bryant 2003 - Bryant D, Maxwell K, Taylor K, et al. Smart Start and preschool child care quality in NC: Change over time and relation to children’s readiness. Chapel Hill: Frank Porter Graham (FPG) Child Development Institute, University of North Carolina at Chapel Hill; 2003.

8 Smart Start-About - Smart Start, The North Carolina Partnership for Children, Inc. About Smart Start.

9 Smart Start - Smart Start & The North Carolina Partnership for Children, Inc.