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Maternal, Child, and Community Health Projects
Oral Health Program Series Meetings
Working as a subcontractor for McKing Associates, HSR continues its oral health work for the Maternal and Child Health Bureau. The Oral Health Program Series meetings convene representatives from the American Dental Education Associate, the Hispanic Dental Association, and the American Association of Community Dental Programs to discuss how dental organizations can collaborate more closely with Head Start programs. For each of these meetings, HSR facilitates planning efforts, gathers and disseminates appropriate background information, and summarizes the forum outcomes in a final report. In preparation for two high-profile national meetings, which will address oral health as it relates to school readiness and birth outcomes, HSR is subcontracting with prominent researchers and epidemiologists to develop background materials and presentations.
Idaho Maternal and Child Health (MCH) Needs and Capacity Assessment
HSR conducted an assessment of MCH needs, capacity, and strengths for the State of Idaho. Due to Idaho's rural topography, the presence of several Tribal entities, and a growing immigrant population, HSR implemented a number of strategies, including focus groups, regional stakeholder meetings, and interviews with community leaders and respected groups, with the objective of enhancing community feedback, participation, and buy-in. The study resulted in a comprehensive assessment and set of recommendations for State policymakers.
Pennsylvania Maternal and Child Health (MCH) Needs and Capacity Assessment
HSR conducted a needs and capacity assessment for the Commonwealth of Pennsylvania, focusing on the MCH service system and the needs of MCH populations, which include children with special health care needs. HSR used a multifaceted approach to gather, analyze, and report data, and the evaluation included both qualitative and quantitative research from primary and secondary sources. HSR also conducted stakeholder meetings across the State and produced findings and recommendations for the State Title V staff and its partners.
New York Attention Deficit Hyperactivity Disorder (ADHD) Study
HSR is studying the quality of care for Medicaid recipients ages 6-12 with ADHD. Conducted for the New York State Department of Health and the State external quality review organization, the study consists of parent focus groups in English and Spanish and interviews with Medicaid managed care organizations and health providers, including pediatricians, family practitioners, and mental health specialists. The final report will include recommendations to the State for developing quality improvement initiatives to improve services to children with ADHD.
Maternal and Child Health (MCH) Training Resource Center
HSR is providing technical and logistical support for the MCH Training Branch to help advance the goals of their strategic plan. HSR will provide data analysis, information management, program coordination and development, strategic partnership development, and meetings management. As part of their technical support, HSR also will facilitate workgroups, produce white papers, and use knowledge transfer strategies to communicate findings and resources to targeted audiences of MCH trainers, students, and professionals.
Evaluation of States' Title V Needs Assessment Activities
In a 2006 evaluation for the Maternal and Child Health Bureau (MCHB), HSR analyzed the impact of State infrastructure-building activities aimed to address the MCHB needs identified in the 2000 needs assessment. In an evaluation that included both qualitative and quantitative analyses, HSR examined trends, promising practices, State implementation and planning, and correlations between infrastructure-building and MCHB outcomes. HSR then translated these research findings to produce a valuable guide, which provides Title V agencies and MCHB programs practical recommendations for conducting MCHB needs assessments.
National Evaluation of the Bright Futures for Infants, Children and Adolescents Initiative
The Bright Futures Initiative, launched in 1990, aims to improve the quality of health services for children through health promotion and disease prevention. HSR conducted the first national evaluation of the Bright Futures for the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau. HSR examined the nature and extent of Bright Futures-related activities through a process evaluation and developed an outcome evaluation plan in collaboration with the Bright Futures Evaluation Workgroup. HSR also conducted a series of case studies exploring how Bright Futures has been used in public child health promotion efforts in seven States. HSR developed a resource guide for States and communities on how to use Bright Futures in their own efforts to improve the health of children and the quality of care they receive. The products of this evaluation are available at:
Using Geographic Information Systems to Improve Oral Health
Geographic Information Systems technology, also known as GIS, has emerged as a valuable analytic tool to assist public health officials in addressing many of the health care issues faced by Americans today. GIS is used to view and analyze multiple types of data through maps and shows patterns and relationships not immediately seen on spreadsheets, thereby informing plans, programs, and strategies to improve population health. HSR worked with the Association for State and Territorial Dental Directors and the Maternal and Child Health Bureau of the Health Resources and Services Administration to broadcast a Web conference in February 2006 to inform the oral health, MCH, and primary care communities about GIS mapping and its use for improving the oral health of children and families in the United States. Titled Improving Oral Health: Using GIS Technology to Target Scarce Resources, this Web conference provides an overview of GIS technology, its role in improving public health, and its capabilities and applications for use at the State and national levels.
The archive of this Web conference is available at:
Chartbook on the Health and Well-Being of Children
As part of its support for the Maternal and Child Health Information Resource Center, HSR produced a new chartbook, The Health and Wellbeing of Children: A Portrait of States and the Nation, 2005. This is the first such publication to assemble data not only on children's health but also on their growth and development, within the context of their family and community environments. The data were obtained from the National Survey of Children's Health, conducted for the first time in 2003. The survey was supported by the U.S. Maternal and Child Health Bureau of the Health Resources and Services Administration and conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This chartbook presents National and State-level findings on children's health and health care, their families, and their neighborhoods.
- http://www.mchb.hrsa.gov/thechild
Child Health USA 2004
HRSA's Maternal and Child Health Bureau has just released Child Health USA 2004 -- an annual report on the health status and service needs of America's children that is produced by HSR. This detailed data book includes statistics for 55 health indicators on infants, children, adolescents, children with special health care needs, and women of childbearing age. Graphics and written summaries highlight long-term trends and information on population characteristics, health status, and health services utilization.
This publication is available online:
- http://mchb.hrsa.gov/mchirc/chusa_04/index.htm
Bright Futures for Infants, Children, and Adolescents Initiative
This effort, launched in 1990 with funding from the MCHB, fosters a developmentally based approach to childhood health promotion and disease prevention in the context of families and communities. In 2002, HSR was awarded a contract to conduct the first national evaluation of Bright Futures. Under this contract, HSR has conducted a large process evaluation to assess Bright Futures-related dissemination, adoption, and practice activities at the national, State, and community levels. HSR also developed an annotated bibliography of Bright Futures materials and collaborated with a group of Bright Futures stakeholders to develop an outcome evaluation plan for this initiative. HSR currently is conducting case studies in six States that are actively using Bright Futures in their child health promotion efforts.
Copies of the process evaluation report and other resources are available at:
Needs Assessment
Effective maternal, child, and community health polices and programs are based on a thorough understanding of the needs of women, children, and families. To gain such understanding, HSR has conducted several needs assessments using both quantitative and qualitative research methodologies. For example, in Montana, we surveyed families of children with special health care needs; in Missouri, we surveyed physician capacity. HSR also conducts needs assessments required by the Federal Maternal and Child Health Bureau as a component of the maternal child health block grants. We currently are designing and implementing the federally required comprehensive Title V needs assessment for the Commonwealth of Pennsylvania and the State of Idaho.
Promotion of Interagency Collaboration
MCCH does not belong to any single discipline, agency, or organization. For this reason, it is important that all MCCH stakeholders work together to achieve shared goals and to maximize resources. HSR has undertaken a number of activities in this area, including the following:
- For the Catholic Health Association and Catholic Charities USA, HSR conducted a nationwide study to assess collaboration among the constituents of the two organizations at the local level and to determine what promoted and what impeded collaboration. After analyzing information from more than 1,500 community-based agencies, we developed an easy-to-use manual detailing steps local agencies can take to collaborate with their partners and thereby improve the availability and accessibility of services.
- For the U.S. Department of Agriculture and HRSA's Primary Care Bureau, we conducted a nationwide study to assess collaboration between community and migrant health centers, Indian Health Service clinics, and Women, Infants, and Children (WIC) agencies. We developed an engaging handbook that featured various models of collaboration and a step-by-step guide for health services and WIC agencies.
Systems Building
Under three nationwide initiatives funded by the Health Resources and Services Administration's Maternal and Child Health Bureau, HSR has provided technical assistance (TA) designed to strengthen State and local systems of care for children and families. As part of the most recent project, Early Childhood Comprehensive Services, we provided TA to grantees to promote the integration of services for children and their families. The focus of the TA ranges from strategic planning to coalition development to evaluation.
Evaluation of State Programs
HSR conducted an evaluation of outreach and enrollment mechanisms to promote and enroll children in the State Children's Health Insurance Program (SCHIP) and Medicaid programs in several States, including Virginia, Maryland, and Mississippi. We also conducted a nine-State focus group study of SCHIP for the Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation. In these, as in other projects, we synthesize information from both quantitative and qualitative research methods to provide complete assessment of the programs' strengths and weaknesses.
Evaluation of Public Education Programs
For the National March of Dimes (MOD) Foundation, HSR designed and conducted an assessment of the role of local MOD chapters, State folic acid councils, and the national partners advisory group in the Foundation's national campaign to promote appropriate intake of folic acid by women of childbearing age. After analyzing the data from our survey and key-informant interviews, we prepared a report that set forth recommendations to improve this important health education initiative.
Redesign of State Systems of Care
For Virginia and Wisconsin, HSR created and implemented a process that identified issues related to strengthening systems of care for children with special health care needs (CSHCN). We used quantitative and qualitative research to gather information from stakeholders, including families of CSHCN and providers, and analyzed these data. On the basis of this research, we proposed concrete and practical recommendations for the redesign of the CSHCN systems in these States. A majority of our recommendations have been implemented successfully.
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