What We Are Learning

Not just surviving. Set the bar at Thriving.

The Pittsburgh Study embraces research for action and advocacy. We face immediate and long-term barriers to child thriving and health equity. This effort includes two primary types of research: program studies (interventions) and systems studies (research over time).

Much health research focuses on disease, death, and deficits. This perspective tends to blame individuals for their choices and problems. Our Study adopts a strength-based approach focused on positive health, healthy relationships, and health equity in community pediatric health.

The standard for the Pittsburgh Study is whether children and young people are thriving. All young people deserve to transition to adulthood with meaningful hope for their future with the skills, knowledge, and tools for success. The Study is focused on co-creating and implementing programs and systems that serve children and young people.

Program studies

This part of the Study develops community-partnered, evidence-based programs. It tests how well programs and practices work to improve a child’s health and to support health equity. Our programs that combine evidence-based interventions aim to show quick results. The intervention studies are run by five groups.

Thriving changes as a child grows. Attention to each stage is crucial. Contexts and events earlier in life influence later stages. Later stages build on earlier wins. There are five stages in the Study with a scientific committee for each: Pregnancy, Early Childhood, Early School-Age, Middle Childhood, and Adolescent. Each scientific committee has representation and leadership from both academia and folks from the community. The vision for each stage’s program combines being developmentally appropriate, trauma-sensitive, equity-focused, and community-partnered.

The Pregnancy Collaborative focuses on full-term birth following a safe, healthy, and supported pregnancy, especially where there are longstanding disparities in outcomes.

The Early Childhood Collaborative tailors supports for positive parenting from infancy through preschool children. Respect for the autonomy of caregivers and strengths-based practices inform the interventions. This collaborative is testing the effectiveness of support programs based on family strengths and challenges coupled with family choices in programming. School-readiness is the key measure.

The Early School-Age Collaborative is co-creating the 3Rs: Reading, Racial Equity, and Relationships. The 3Rs are grounded in coming together around racially affirming books at home, at school, and after school. School- and district-level leadership participate. The 3Rs aim to boost reading proficiency and close the gap between Black and white children’s reading levels.

The Middle Childhood Collaborative builds restorative practices in schools to establish a healing-centered school climate. This model centers highly-trained relationship builders working full-time to fill the school with respect, accountability, and love. Enhanced educational achievement and focus on restoring relationships replaces exclusionary discipline and law enforcement involvement.

The Adolescent group works with middle school students to build positive school engagement and affirm self-identity. The curriculum focuses on gender equity and respect, recognizing abuse and its impact on self and others, regulating emotions, skills for healthy relationships, and becoming active proponents of safe and healthy relationships. The Adolescent program for high school-aged youth happens not in schools, but in community settings, including community organizations, youth-serving agencies, and Black churches. This effort is designed for youth exposed to neighborhood violence. Youth leaders address racial and gender justice.  They also challenge implicit bias among law enforcement officers. Achieving educational goals, strengthening youth-adult relationships, and addressing impacts of trauma and racism in transformative ways are the outcomes of this program.

These groups work in connection with one another to weave a unified progression of programs. They are coordinated to enhance child thriving and health equity. The Study begins with Pregnancy and goes through Adolescence, expanding its scope to match the growth of young people. This arc stretches from healthy pregnancy to positive, early home life → to learning to read to learn with adult allies in and out of racially affirming schools → to being supported in building a healing-centered school → to facilitating change in gender and racial inequities in safe spaces → and transition toward neighborhood transformation.

At each stage, science tied to action enhances an equitable and healthy context in which young people can thrive. The Study lifts up the awesome capabilities and strengths of young people and their care givers. Young people, especially Black youth, are too often underestimated. They deserve much more credit and respect than they typically receive. Their voices need to be heard.

Systems studies

This part of the study will survey families and ask about many aspects of thriving and equity. The surveys are tailored to the development of young people as they grow, starting from pregnancy and progressing through adolescence. These experiences are connected with neighborhood characteristics, environmental conditions, policies, and practices to identify and quantify inequity and advocate for equity and thriving.

This research serves several purposes. It will establish a background of thriving in Allegheny County. It will be used to understand baselines of thriving, health, and disparity. These are useful for accountability, evaluation, advocacy, and guiding next steps. Background and baseline levels are hard to establish without this kind of concerted effort.

Typical research focuses on problems or deficits to be remedied by those who know better. Individuals are blamed, reinforcing stigma and shame. Listening and learning from local wisdom is harder when targeting problems. Our focus on thriving with an anti-racist framework led us to learning from “bright spots.”  Bright spots are individuals or communities successfully adapting to and overcoming structural barriers and institutionalized oppression and discrimination. A bright spot is a place where people are doing better than surviving. Our neighborhoods have much to teach each other and our nation. There is something to learn in every bright spot. There is something to lift up and celebrate. There are folks making a difference and deserve to be recognized. Their work is valuable. Their stories, practices, and leadership meaningful.

The long-term part of the study is closely tied to four cross-cutting scientific committees, which will pay special attention to Health Services Delivery, Policy and Place, Data Access, and Healthy Environments/Strong Bodies. Understanding neighborhood characteristics and local policies and practices makes disparities visible, suggests paths toward equity, and highlights adaptations to learn from and lift up.

Programs and systems working hand-in-hand

Whenever possible, participating children and their adults will be invited to move through the programs as their children grow. All families in Allegheny County will be invited to join in the long-term THRIVE study and be notified if they qualify for the age-based programs. We welcome and appreciate as much participation and partnership as possible. The richer the data, the stronger the drive behind efforts to undo oppressive policies and inequitable practices.

This is an opportunity to make as much change as fast as we can and involve as many in that change as possible. The personal stories in the data need to be lifted up. What we know works isn’t being done. Too many Black and Brown children are dying. Too many are just surviving. We need to push toward thriving children, families, and communities.

The Pittsburgh Study’s work is to be worthy of being Pittsburgh’s Study. Allegheny County has much to learn from its history, its residents, its scientists, but mostly its young people. This is an opportunity to do the work of undoing racism and build toward a new normal that works for everyone, especially our children and youth.