Smart Start North Carolina

Program basics

  • Comprehensive, statewide early childhood initiative providing communities with funding for educational childcare, health care, and family support services
  • Communities have flexibility to design programming to meet specific needs
  • Series of public-private partnerships between the state, counties, and private, independent organizations prioritizing localized control to provide and fund critical services to families

Strength of evidence

Evidence level: Strong (second-highest tier)


Strong (second-highest tier)

Ranked as having the second-highest level of evidence by County Health Rankings and Roadmaps

Target population

Preschool-aged children

Program cost

Not available

Implementation locations

  • North Carolina

Dates active


Outcomes and impact

  • Some evidence for improvement of school readiness, particularly for disadvantaged children
  • Children from low-income families experience greater improvements in school readiness than peers who attend other day care centers
  • Children from higher income families do not receive additional benefit compared to other childcare programs
  • Participation linked to higher third-grade test scores in reading and math and decreased likelihood of special education placement
  • Participating children more likely to receive vaccines and have access to regular health care
  • Promotes early literacy and literacy-related outcomes
  • Improved child health through improvements in nutrition, physical activity, and health and safety practices

Keys to successful implementation

  • Note: This content is under review
  • Fostering trust and collaboration with families is essential to program success. Transparency and clear communication between providers and families strengthens these relationships.
  • Training and oversight helps local organizations and program facilitators meet benchmarks and operate the program more effectively.
  • As communities may have different service needs, flexibility in offerings can increase positive outcomes and strengthen trust

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