In October, AAP-CA3’s Allyson Cruz-Edquid, Miriah de Matos, and Shelby Smith spoke at Healthy Families America’s (HFA) Live Virtual Conference on behalf of the chapter’s Family Support Program, which utilizes the HFA model. 

In a presentation titled, “Once Upon the Parallel Process: A Systems Approach to Ensuring the Platinum Rule,” the AAP-CA3 team shared stories of their journey utilizing the parallel process in practice across all roles and relationships in the countywide Healthy Families America (HFA) multi-site system. HFA defines the parallel process as encompassing all the relationships within the system and focusing on each person’s ability to develop and promote nurturing relationships. Here are some of the highlights from the presentation: 

Since the pandemic, our systems and nation have faced increasingly stressful circumstances from fatal illness, racial reckoning, and political violence. While these stressors were not new for many staff and families in our programs, there was now an open space for dialogue and reflection on changing systemic barriers exacerbating the stressors.  These issues coincided with the need for programs to shift from in-person to virtual, which added barriers to building what Dr. Bruce Perry has coined as attachment elements, including safety, predictability, comfort, and pleasure in our HFA multi-site system. 

As witnesses and participants of these experiences, the Healthy Families San Diego Central Administration team began to challenge traditional ways of engaging, often rooted in systemic barriers, to rebuild attachment elements and elevate staff strengths. This shift required considering perspectives across the parallel process, incorporating the diverse needs of unique staff and roles, and uplifting the platinum rule—”Do unto others as you would have others do unto others.” The rule coined by Jeree Pawl, a trailblazer in the field of infant mental health that lay the framework for programs like HFA. 

The team shared examples of changes to help shift other HFA sites or member practices. For communication, this included transforming long narrative emails in black and white text to playful and engaging infographics that still provided detailed information but with color, text boxes, enhanced formatting, and even staff Bitmojis to offer a face to the information being shared. In training, many of the same approaches around shifting how information is shared, but this expanded to formatting slides with dark backgrounds for visual processing. Staff provided tech support during zoom meetings, increased access and inclusive virtual trainings with strategies like repeating questions or key details in zoom chat to provide additional opportunities for all staff to engage and process what was being conveyed. 

In quality assurance and policy, these same practices were applied to increase interest and access regardless of education level or primary language. These shifts were coupled with new ways of providing strength-based feedback and ongoing technical assistance from a place of partnership. The team worked to reduce hierarchies and increase dialogue through frequent connections and open invitations to all levels of staff. Parallel to the effort to create content that was more visually engaging in the fore-mentioned functional areas, evaluation and quality assurance data had been on a parallel journey. AAP-CA3’s Senior Data Specialist crafted a system using Tableau Analytics. Tableau took what could have been pages of excel spreadsheets and created easy to understand tables and graphs. These visuals not only communicated progress towards meeting the Best Practice Standards but began to engage even non-data minded readers. This provided greater space for sites to begin to use what they had learned in the data to better support quality improvement efforts. 

Since the conference sites across the country have reached out to AAP-CA3 to learn more. The team is eager to continue this work as they partner with public health nurses.