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La Linda Manita: Community Based Early Parent Education In the Community Health Center Setting

Friday, October 19, 2012
Room R06-R09 (Morial Convention Center)
Anne Nugent, MD, MPH, Pediatrics, Holyoke Health Center, Holyoke, MA

Case Report:

La Linda Manita is an innovative intervention aimed at improving developmental outcomes for low-income Latino families by offering parent education and support workshops emanating from the pediatric department of a Community Health Center (CHC).


On state-mandated developmental/behavioral health screening, approximately 1/3 of children at our CHC have a screen indicating a need for referral for services. Significant disparity exists in the prevalence of positive behavioral screens in our population compared to the region as a whole. The recent AAP policy statement on Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician (Pediatrics 2012;129;e224) highlights the ways in which early environmental influences have long lasting effects on learning capacities, adaptive behaviors and physical and mental health. There is an enormous disparity in access to this information. While the importance of early stimulation and verbal interaction with children has permeated most middle class communities, this message has tended not to trickle down into low-income areas, where families are often overwhelmed and disconnected by language or culture from mainstream information.  The La Linda Manita program was designed to address directly the critical role of parents in the earliest years of child development in setting the stage for meeting their behavioral and intellectual needs later in life.

Program Design

La Linda Manita was developed by a CATCH grant funded planning committee which created a partnership between a CHC and several agencies serving families of preschool children. Program curriculum and logistics were developed based on research conducted among parents and educators contacted through partner agencies.

            Between July 2011 and June 2012, six 8-10 week sessions of bilingual parenting classes were offered onsite at our CHC for parents of very young children using an evidence-based curriculum.  Parent groups were facilitated by trained bilingual, bicultural parent educators who are living and raising children in the community.    


Effectiveness of the program was measured quantitatively (pre and post survey) and qualitatively (focus groups).

Key findings:

            79% of enrolled participants graduated from the groups

            8 Partner organizations remained actively involved

            Participant satisfaction was very high

Qualitative data revealed knowledge and skill development in the areas of:

Normal child development/ normal behaviors

Importance of communication and social interaction with children

Importance of parent /child bonding

Reducing social isolation

Emotional self-regulation (parents and children)


The La Linda Manita model represents an innovative, preventive approach to behavioral/developmental issues that are highly prevalent in low-income urban CHC populations. It uses the strength of the partnership between pediatricians and community early childhood agencies to develop peer-led parenting support and education programming.  Early results are promising, and wider use of the model with ongoing evaluation will allow for further development of this important adjunct to pediatric care.