In 2023, child care health advocates and partners convened to develop A Strategic Vision for the Child Care Health Consultation System in King County. This strategic vision includes actionable recommendations and foundational investments needed to build the CCHC system in King County, which includes four system components (see Figure 1).
One of those system components is on monitoring and evaluation. To meet our strategic vision goals, objectives, and strategies, we’re excited to share a new evaluation guide that provides a planned approach to evaluating the CCHC system building components.
The full evaluation guide includes: a CCHC system theory of change; a systems framework to guide the evaluation; and evaluation objectives, questions, measures, methods, and dissemination strategies.
Measuring impact and our approach to data
The CCHC systems evaluation is grounded in two key frameworks: Results-Based Accountability™ (RBA) and The Water of Systems Change.
RBA, used across many Best Starts for Kids strategies, is a data-driven approach that focuses on three core questions: How much did we do? How well did we do it? Is anyone better off? These guide both evaluation questions and measurement.
The Water of Systems Change, developed by FSG, provides a lens for understanding and supporting lasting change across six interconnected conditions: policies, practices, resource flows, relationships and connections, power dynamics, and mental models.
Together, these frameworks help assess and strengthen the sustainability of the CCHC system in King County. Learn more about RBA and The Water of Systems Change framework on page 10 of the evaluation guide.
Where are we now in building and evaluating the CCHC System?
System Building Activities:
- Oct 2024: Partnered with Best Starts’ Infant and Early Childhood Mental Health strategy to develop a 9-month Community of Practice for child care providers and CCHCs (ended June 2025)
- Feb 2025: Launched a King County Child Care Health Consultant Registry to better connect child care providers to CCHCs and for CCHCs to learn about their peers
- May 2025: Launched a Community of Practice for Child Care Health Consultants serving Family, Friend, and Neighbor caregivers (through Dec 2025)
- Currently building a Networking and Resource Hub for CCHCs to connect, exchange resources, and foster a community with one another (anticipated launch by October 2025)
- Currently planning one new Community of Practice for CCHCs
System Evaluation:
- Cardea has conducted interviews with child care providers, health consultants, and CCHC systems leaders to better understand the early impacts of our system-building activities and provide actionable recommendations for continued system-building work.
- Cardea is working with our CCHC Evaluation Advisory Group to design a data dashboard (planned release: early 2026).
Questions?
If you have any questions about Best Starts’ CCHC Systems work, please reach out to Lucy Dong, Child Care Health Consultation Program Manager, at ludong@kingcounty.gov.
