Photo of children hugging

Children grow up in environments that promote optimum health
and children and their families are able to receive the coordinated care and services they need to ensure that all children achieve their full potential.

Child and Youth Development, a Critical Systems Issue

The early years are a critical period of growth and development. Numerous studies have demonstrated that the experiences and environments that children are exposed to during their formative years play instrumental roles in shaping their futures.

Positive and negative health, social, emotional, and economic consequences often can be predicted from exposures traced back to childhood.

Current models of healthy childhood development support the need to address multiple domains—early care and education, social and emotional development, family support services, parent education, and health care—by using a systems-based approach that involves the collaboration and partnership of multiple agencies and individuals.

Altarum Institute’s Center for Healthy Child and Youth Development aims to serve as a catalyst in promoting progress in healthy child development by operating simultaneously as a research center, technical assistance provider, policy advocate, and partner to organizations with similar goals.

Our Core Strategies for Approaching This Work

Altarum’s work employs a socioecological approach that addresses children, their families, the organizations that serve them, and the communities in which they live, work, and play. In partnership with other leading organizations we:

  • Evaluate, research, and assist efforts that seek to improve child, family, and systems outcomes related to healthy child and youth development;
  • Leverage Center resources to enhance connections between the fields of child and youth development and childhood obesity prevention;
  • Advocate for and disseminate systems change strategies at the organizational, local, state, and national levels; and
  • Build new and sustainable infrastructure and capacities for Altarum and its partners.

Altarum's History in Promoting Healthy Child and Youth Development

The Institute’s work in early childhood system building initiatives dates back to the mid-1990s. Early work centered on providing technical assistance to a variety of initiatives funded through the Maternal and Child Health Bureau. Altarum’s efforts supported 112 Community Integrated Services grantees, the Healthy Child Care America initiative, and the Early Childhood Comprehensive Systems Initiative. Together, these efforts involved work with leading national early childhood organizations and teams of expert practitioners in every state.

In 2008, Altarum invested $2.5 million over a 2-year period in its Childhood Obesity Prevention Mission Project (CHOMP). Through CHOMP, Altarum staff conducted five early childhood obesity prevention projects in nine states and Washington, D.C. These efforts focused on improving environments and policies related to early childhood education and care systems; the Supplemental Nutrition Program for Women, Infants, and Children; and registry-based body mass index surveillance systems for monitoring the obesity epidemic in young children.

Center Initiatives and Partners

Verification of Partner Commitments—Partnership for a Healthier America

Altarum develops and implements verification plans for Partnership for a Healthier America, a nonprofit organization that works alongside, but independently from, First Lady Michelle Obama’s Let’s Move! initiative to garner commitments of significance from the private sector to reduce childhood obesity. Altarum develops verification methods, describes performance metrics, and identifies data sources to monitor partner commitments. Examples of verification work include using geographic information systems to assess grocery store location relative to food deserts, assessing changes to hospital food environments through menu and document review, and assessing physical activity offerings in communities.

4x4 Health and Wellness Initiative Community Coalitions—Michigan Department of Health and Human Services

Altarum is the evaluator for the 4x4 Health and Wellness Initiative Community Coalitions project, which is designed to promote health and reduce obesity by creating healthier communities, expanding prevention activities, and empowering people to make healthy choices and adopt health as a personal core value. Altarum evaluates the outcomes of grantee work focused on policy, systems, and environmental changes and social support programs to reduce rates of chronic disease. Initiatives evaluated have included food pantries, grocery stores, community supported agriculture, farmers markets, restaurants, shared use agreements, fitness classes, and trail signage.

Michigan Health Endowment Fund Project Evaluation—State Alliance of Michigan YMCAs

This initiative is designed to improve the health of Michigan youth and older adults through three types of activities: improving nutrition and physical activity practices and policies in before/after school and summer programming, providing low-income youth with instruction on learning to swim and swim safety, and building capacity to implement chronic disease prevention programs for adults in high-need communities. Over a 2-year period from 2015 to 2017, the State Alliance of Michigan YMCAs worked with Michigan’s 27 independent Y associations to conduct activities in one or more of the 3 program areas. Altarum served as the project evaluator, developing and implementing an evaluation plan to assess outputs and outcomes related to project activities and describe how these activities affected the health of youth and older adults in Michigan.

Halting Obesity in Pregnancy Through Early Childhood, Nemours Children’s Health System and American Academy of Pediatrics

Project HOPE is a joint initiative of Nemours Children’s Health System and American Academy of Pediatrics with a goal of ensuring all children enter kindergarten at a healthy weight. The project intends to accomplish this through working with a national network of organizations and selected states to advance a common action agenda of research-based protective and risk factors that affect healthy weight and child development, particularly during the first 1,000 days of life. Altarum provided evaluation support to the initiative, including working with partners to design a theory of change and logic model for the project, and identifying output and outcomes measures and data collection sources.

Healthy Weight and Your Child—YMCA of the USA

Altarum conducted an evaluation of YMCA of the USA’s evidence-based Healthy Weight and Your Child program, an intervention program targeting children ages 7-13 years of age who are in the 95th Body Mass Index (BMI) percentile. Altarum evaluated the implementation of this program in a cohort of five YMCAs, conducting key informant interviews with Y staff, health care partners, and child participants and focus groups with parent participants. Based on the evaluation findings, Altarum provided a set of recommendations to improve implementation of the program as it rolls out to Ys across the country.

Building Healthy Communities: Step Up for School Wellness—Michigan Department of Health and Human Services

Altarum is an evaluator for the Building Healthy Communities: Step Up for School Wellness program, a school-based grant program designed to empower school leaders to build healthy school environments that foster a culture of wellness. Schools follow a step-wise process over the course of one school year, where they engage a school team, assess the school environment, take actions to improve healthy eating and physical activity, evaluate their actions, and share their success. Altarum conducts surveys with grantees across Michigan and compiles data on program implementation characteristics, success, challenges, and lessons learned.

Physical Activity and Healthy Eating in Before/After School and Summer Programs—Michigan Department of Health and Human Services

This program aims to increase physical activity and healthy eating and increase enrollment in before/after school and summer programs in Michigan. Altarum conducts quarterly progress report surveys of grantees to monitor progress on implementation activities; conducts annual site visits and observations of site operations to assess quality of programming and environments; and conducts key informant interviews to gather contextual and supporting information, successes, challenges, and lessons learned from grantees. Altarum also developed a program infographic to use to promote the program with state policymakers.

Healthy Eating & Physical Activity in Early Childhood and Afterschool Programs—YMCA of the USA

Altarum conducted a four-year study of the implementation of the YMCA’s Healthy Eating and Physical Activity Standards in early childhood and afterschool programming at YMCAs serving more than 700,000 youths nationwide. Approximately 700 YMCA associations from across the U.S. participated in the mixed-methods study, which utilized survey, interview, and direct observation methods in concert with a robust document review process to measure and track program progress in implementing best practices in nutrition and physical activity.

Healthy Eating and Physical Activity Standards Training Evaluation—Y-USA

Building Healthy Programs for Kids: Healthy Eating and Physical Activity Standards Training is a Y-USA course for afterschool providers on healthy eating and physical activity standards. Altarum used the Kirkpatrick Method to assess the effectiveness of this course in helping local Y’s to implement healthy living standards afterschool programs.

Eat Well, Play Hard in Day Care Homes—New York State Department of Health

Based on their evidence-based intervention, Eat Well, Play Hard in Child Care Settings, New York State Department of Health launched the Eat Well, Play Hard in Day Care Homes project, one of the first interventions in the country targeted specifically at preventing obesity in family day care home environments. The goal of this 12-month intervention was to improve the nutrition and physical activity environments and practices of family day care homes. Altarum conducted an evaluation of this project to assess behavioral and environmental outcomes as well as the potential for more widespread dissemination of this model.

Start Right Up Evaluation—Women’s Housing and Economic Development Corporation

The Start Right Up initiative aims to improve the economic stability of home-based childcare providers and the quality of care provided to children in home-based childcare settings. Altarum designed the evaluation, assisting with data collection and analysis, and developing annual reports related to project outcomes for the Kellogg Foundation. Results from the evaluation will help inform the efforts of similar organizations involved in improving the quality of home-based childcare services in low-income, ethnically diverse communities.

Year Round Feeding Program Evaluation—YMCA of the USA

 Altarum conducted a study of 150 YMCAs to assess how Ys develop the infrastructure needed to establish year round feeding programs. These programs aim to address childhood obesity and childhood hunger by increasing the number of YMCAs participating in the Child and Adult Care Food Program. In addition to establishing infrastructure to deliver year round feeding programs, Altarum assessed key partnerships associated with program success, and facilitators and barriers to implementation through surveys, key informant interviews and site visits.

Nutrition Environment Assessment Tool Revision—Michigan Department of Health and Human Services

The Nutrition Environment Assessment Tool (NEAT) is an online, self-assessment instrument designed to help communities assess their environment to determine whether it supports healthy eating. Altarum conducted a thorough literature review of assessment instruments and metrics in community sectors and developed new sections and questions for this tool, including child care, farmers markets, food pantries and food banks, grocery stores, small stores, hospitals, out-of-school time programs, restaurants, schools, vending, and workplace sectors.

Local Health Department/Community Health Center Collaboration Issue Brief and Tool—National Association of County and City Health Officials (NACCHO)

Altarum worked with the National Association of County and City Health Officials to develop an issue brief and collaboration tool encouraging collaboration between local health departments and Community Health Centers, including Federally Qualified Health Centers. Altarum completed a literature review, survey of local health departments, and virtual focus groups with representatives of both types of organizations in developing an issue brief and collaboration tool that are available on the National Association of County and City Health Officials’ website.

Promoting Positive Parenting (Triple P)—National Association of County and City Health Officials

Altarum conducted an evaluation of the implementation of Triple P through partnerships between local health departments and Federally Qualified Health Centers in two communities. Triple P is an evidence-based system of interventions designed to enhance parental knowledge, skills, and confidence to prevent behavioral, emotional, and developmental problems in children.

Blood Pressure Self-Monitoring Evaluation—YMCA of the USA

Altarum conducted a set of evaluations of the YMCA’s evidence-based Blood Pressure Self-Monitoring program. One of the evaluations focused on partnerships with health care providers and other Y programs. Altarum staff conducted a literature review and key informant interviews and focus groups with Y staff and health care providers. The other evaluation was a study of the feasibility of using simulations to assess program fidelity. Y staff were trained in acting as program participants and recording their interaction with Healthy Heart Ambassadors who support program participants.

Community Transformation Grant—Y-USA

Altarum worked with YMCA of the USA to conduct a comprehensive evaluation of their Community Transformation Grant. The goals of this project are to expand the YMCA Diabetes Prevention Program to reach more African-American/Black and Hispanic/Latino populations, implement healthy eating and physical activity standards in early childhood and afterschool programs serving these populations, and achieve jurisdiction-wide health impact through implementation of jurisdiction-wide changes.



The Center for Healthy Child and Youth Development is led by Karah Mantinan, MPH, RD, deputy director of the Center, and Chris Botsko, senior specialist in community and systems change.

Ms. Mantinan is a project director in Population Health Strategies at Altarum, where she manages research and evaluation projects that focus on nutrition, physical activity, obesity prevention, chronic disease prevention, and community-based initiatives.

Mr. Botsko is a Senior Consultant with Altarum where he focuses on the evaluation and support of research-based practices to improve the health of children, youth, and communities.

To learn more about the ongoing work of the Center, please email or