Opportunities for Collaboration: the MCHB Title V Block Grant and Healthy Start

Transcription

1 Opportunities for Collaboration: the MCHB Title V Block Grant and Healthy Start Presented by Suzanne Richards-Eckart, Region VII MCH Consultant DHHS/HRSA Maternal and Child Health Bureau Division of State and Community Health

2 Acknowledgements Veni Kandasamy, MHS ORISE Fellow, MCHB Office of Epidemiology and Research, Ashley Hirai, PhD Senior Scientist, MCHB Office of Epidemiology and Research Coders Carolyn Gleason and Jennifer O Brien MCHB Division of State and Community Health

3

4

5 This image cannot currently be displayed. This image cannot currently be displayed.

6 Title V Maternal and Child Health Block Grant to States Program Funding based on the number of children in poverty Matching grant program 30% for services for children with special health care needs 30% percent for preventive/primary care services for children 5 year Needs Assessment priority needs selection of measures selection of strategies

7 MCH Block Grant Three Tier Performance Measure Framework National Outcome Measures National Performance Measures Evidence-Based or Evidence-Informed Strategy Measures 7

8 MCH Block Grant Performance Measure Framework National Outcome Measures (NOMs) are for population health assessment 15 National Performance Measures (NPMs) identified across 6 population domains As available, NPMs and NOMs are drawn from national data sources and prepopulated for States to analyze. If data are not available, States will provide their own data. Evidence-based/informed strategy measures (ESMs) are key to understanding and demonstrating impact of Title V investments on NPMs and longer term NOMs. Not just showing that NPMs/NOMs change but how Title V may influence those changes 8

9 National Performance Measures # Short Title Data Source MCH Population Domain 1 Well-woman visit BRFSS 2 Low-risk cesarean delivery NVSS Women s/maternal 3 Risk-appropriate perinatal care NVSS + AAP 4A,B Breastfeeding initiation and exclusive through 6 months 5 Safe sleep PRAMS NIS Perinatal/Infant 6 Developmental screening NSCH Child 7 Injury hospitalization 0-9 years and years HCUP-SID 8 Physical activity 6-11 years and years NSCH, YRBSS 9 Bullying perpetration and victimization NSCH, YRBSS 10 Adolescent well-visit NSCH 11 Medical home NSCH 12 Transition NSCH 13A,B Preventive dental visit during pregnancy, childhood PRAMS, NSCH 14A,B Smoking during pregnancy NVSS, NSCH 15 Adequate insurance NSCH Child and/or Adolescent Adolescent CSHCN Cross-cutting/Life course

10 Opportunities for Alignment and Assistance # NPM Program CoIIN Resource Center CMS Core Quality HEDIS- Measure Set NCQA 1 Well-woman visit Healthy Start Access to Care Postpartum visit X 2 Low-risk cesarean Healthy Start Alliance for Innovation Low-risk cesarean delivery in Maternal Health 3 Risk-appropriate perinatal care Infant Mortality Proposed 4 Breastfeeding Healthy Start Home Visiting Leadership Education in MCH Nutrition Program Home Visiting 5 Safe sleep position Healthy Start Home Visiting Infant Mortality National Action Partnership to Promote Safe Sleep 6 Developmental screening Home Visiting Home Visiting Leadership Education in Neurodevelopmental and Related Disabilities (LEND) Developmental Screening 7 Injury hospitalization Child Safety Children's Safety Network EMS National Resource Center 8 Physical activity Leadership Education in MCH Nutrition Program Weight Assessment and Counseling 9 Bullying HRSA Bullying Children's Safety Network Prevention Initiative 10 Adolescent well-visit AYAH AYAH National Resource Center Adolescent well-care Leadership Education in Adolescent Health visit 11 Medical home Healthy Start D70 - systems National Center for Medical Home Improvement CAHPS (all children and integration LEND chronic conditions) 12 Transition Got Transition LEND 13 Preventive dental visit Oral Health Oral Health Resources Center Preventive Dental Services 14 Smoking Healthy Start Infant Mortality Smoking and Tobacco Use Cessation 15 Adequate insurance Healthy Start Catalyst Center X X X X

11 State Priorities, State Performance Measures and State Outcome Measures

12 Most Common State Priorities in 2015 Topic # (%) Access to Care and Health Status 59 (100%) Improving Health OR Access to Health Care 55 (93%) Improving Health 37 (63%) Improving Access to Health Care 48 (81%) Medical Home OR Care Coordination 40 (68%) Disparity Reduction 20 (34%) Oral Health OR Access to Oral Health Care 27 (46%) Mental Health and Access to Mental Health Care 29 (49%) Specialists, Screening, Immunizations, Other Care 46 (78%) Developmental Screening/Early Intervention 29 (49%) Transition Care 20 (34%)

13 Most Common State Priorities in 2015 Topic # (%) Healthy Pregnancies 55 (93%) Prenatal, Pre- and Interconceptional Health and Health Care 46 (78%) Preconceptional or Interconceptional Care 39 (66%) Pregnancy Outcomes-LBW and IM and MM 41 (69%) Infant Mortality 39 (66%) Healthy Living 54 (92%) Healthy Lifestyles in General, Nutrition, Exercise, Weight 49 (83%) Obesity and Overweight 20 (34%) Nutrition and/or Exercise 19 (32%) Breastfeeding 25 (42%) Risk Behavior in General, Substance Use, Sexual Risk 33 (56%) Any Substance Use 30 (51%) Tobacco Use 25 (42%) Drug/Substance Use 17 (29%) Miscellaneous/Uncategorized 33 (56%) Support Families/Parenting/Healthy Relationships 19 (32%) Injury Prevention 28 (47%)

14 National Overview of SPMs and SOMs 509 unique needs 232 State Performance Measures (SPMs) 158 SPMs were unique 30 SPMs were either the same as or similar to an NPM 38 SPMs were either the same as or similar to an NOM SPMs that were deemed similar to an NPM or NOM examined some variation of measure (by a stratifier or more or less specific etc.) 20 State Outcome Measures (SOMs) 15 SOMs were unique 5 SOMs were either the same or similar to an NOM

15 Most Common SPMs/SOMs not overlapping with NPM/NOMs Topic # States Healthy Pregnancy 25 Teen Births 11 Agency/Workforce 20 Mental Health 17 Depression 11 Prenatal/Postpartum screening/prevalence 9

16 Suzanne Richards-Eckart, LMSW Region VII Maternal and Child Health Consultant HRSA Maternal and Child Health Bureau Division of State and Community Health (816)

17 IOWA TITLE V AND HEALTHY START PARTNERSHIP OPPORTUNITIES Healthy Start Regional Meeting June 8-9, 2017

18 SELECTED NATIONAL PERFORMANCE MEASURES (8 OF 15) NPM # Performance Measure MCH Population Domain PM 1 Percent of women with a past year preventive visit Women/Maternal PM 4 A) Percent of infants ever breastfed Perinatal/Infant B) Percent of infants breastfed exclusively through 6 months PM 6 Percent of children, ages 9-71 months, receiving a developmental screening using a Child Health parent-completed screening tool PM 9 Percent of adolescents, ages years, who are bullied Adolescent Health PM 10 Percent of adolescents with a preventive services visit in the last year Adolescent Health PM 11 PM 12 Percent of children with and without special health care needs having a medical home Percent of children with and without special health care needs who received the services necessary to make transitions to adult health care CSHCN CSHCN PM 13 A) Percent of women who had a dental visit during pregnancy and B) Percent of infants and children, ages 1-17 years, who had a preventive dental visit in the last year Cross-cutting

19 SELECTED STATE PERFORMANCE MEASURES SPM # Performance Measure MCH Population Domain PM 1 Percent of CYSHCN who meet criteria for Quality of Care CYSHCN PM 2 A) A) Percent of children 0-21 served by Title V who report a medical home Cross Cutting B) B) Percent of women served by Title V who report a medical home PM 3 Percent of children with a payment source for dental care Child Health PM 4 Percent of early care and education programs that receive Child Care Nurse Child Health Consultant Services PM 5 Percent of adults aged who report being physically active Adolescent Health

20 MEASURES & STRATEGIES BY DOMAIN: WOMEN & MATERNAL HEALTH NPM: Well-women visit (past year) ESM: Percent of Title V maternal health participants that received education on continuing their health care coverage Potential Collaborations with Healthy Start: Increase health insurance access to women Ensure all Title V Maternal Health clients receive post-partum follow up

21 MEASURES & STRATEGIES BY DOMAIN: PERINATAL/INFANT HEALTH NPM: Breastfeeding (ever breastfed; exclusively through 6 months) ESM: Percent of women educated on the importance of breastfeeding to ensure that the feeding decision is fully-informed. Potential Collaborations with Healthy Start: Educate pregnant women on benefits and methods of breastfeeding Discharge planning for ongoing breastfeeding support Promote breastfeeding education to maternal health nursing staff Establish links among birthing hospitals and community breastfeeding support networks in Iowa

22 MEASURES & STRATEGIES BY DOMAIN: CHILD HEALTH NPM: Developmental Screening (10 through 71 months) ESM: Percentage of Medicaid enrolled children ages 0-6 receiving a developmental screen using a standardized tool according to EPSDT guidelines. ESM: Percentage of Medicaid enrolled children ages 0-6 receiving a brief emotional behavioral assessment using a standardized tool according to EPSDT guidelines. SPM: Percent of early care and education programs that receive CCNC SPM: Percent of children with a payment source for dental care Potential Collaborations with Healthy Start: Promote parent and caregiver awareness of developmental screening Promote collaboration between Title V, Early Childhood Comprehensive Systems grant, early care and education, and home visiting providers on the provision of developmental screens Promote the importance of quality child care to parents and caregivers Work with local I-Smile Coordinators for screening, presumptive eligibility and care coordination

23 MEASURES & STRATEGIES BY DOMAIN: ADOLESCENT HEALTH NPM: Preventive medical visit in last year (ages 12-17) SPM: Percent of women educated on the importance of breastfeeding to ensure that the feeding decision is fully-informed. Potential Collaborations with Healthy Start: Promote the importance of annual visits for young parents or older siblings Screen for physical activity of young parents Collaborate with the Healthiest State Initiative to promote wellness activities

24 MEASURES & STRATEGIES BY DOMAIN: CROSS-CUTTING/LIFE COURSE NPM: A) Percent of women who had a dental visit during pregnancy and B) Percent of children, ages 1 through 17 who had a preventive dental visit in the past year SPM: A)Percent of children 0-21 served by Title V who meet Iowa's Title V criteria as having a medical home B)Percent of women served by Title V who meet Iowa's Title V criteria as having a medical home Potential Collaborations with Healthy Start: Work with I-Smile to inform, educate, and disseminate scientific evidence about importance of prenatal dental screening and treatment Assure statewide network that includes dental home referral, tracking, and follow-up for children Assess medical home status of children and adolescents, educate regarding its importance, and refer to medical homes Assist families with health insurance literacy Presumptive eligibility for pregnant women will be done with any client who does not have insurance Identify local resource for prenatal care for low income women and non-citizens without insurance

25 IOWA TITLE V RESOURCES Iowa MCH Website: Iowa s Five Year Needs Assessment Website: Title V Director: Marcus Johnson-Miller Bureau of Family Health Iowa Department of Public Health 321 E. 12 th St, Des Moines, IA Marcus.Johnson-miller@idph.iowa.gov

26 Kansas Title V Program & Healthy Start Partnership Opportunities HEALTHY START REGIONAL MEETING JUNE 8-9, 2017

27 Selected NPMs* (8 of 15) NPM1: Well-woman visit NPM4: Breastfeeding (ever; exclusively 6 months) NPM6: Developmental screening (10-71 months) NPM7: Child injury (0-9) NPM9: Bullying NPM10: Adolescent well-visit (12-17) NPM11: Medical home NPM14: Smoking (pregnancy & household) *National Performance Measures

28 Selected SPMs* SPM1: Preterm births (<37 weeks gestation) SPM2: Children living with parents receiving emotional support (help w/parenthood) SPM3: Physical Activity (child and adolescent) SPM4: Safe sleep trainings provided to professionals SPM5: Health literacy - adults who report it is somewhat difficult or very difficult to understand information from doctors, nurses, and other health professionals *State Performance Measures

29 Measures & Strategies by Domain Women & Maternal Health NPM: Well-woman visit (past year) ESM: Percent of women that received well-woman visit education SPM: Percent of preterm births (<37 weeks gestation) Well woman visit (increase education and access)* Prenatal and postnatal risk screening at every visit* o Prior preterm birth, maternal/perinatal depression, smoking Prenatal care and education (Becoming a Mom )* Progesterone as intervention for preterm birth * Eliminate Early Elective Delivery (EED)* (39 Wks Toolkit/hard stop) Home visiting/mom-baby-family support* *Healthy Start work is aligned/team is actively partnering with Title V

30 Measures & Strategies cont Perinatal & Infant Health NPM: Breastfeeding (ever breastfed; exclusively through 6 months) ESM: Percent of WIC infants breastfed exclusively through six months in designated Communities Supporting Breastfeeding Communities supporting breastfeeding (cross-sector approach) * High 5/Baby-Friendly hospitals (increase # that are designated) * Optimal infant feeding/breastfeeding support (peers, home visitors, WIC) and nutrition education (prenatal and postpartum) * Infant feeding: consistent materials, education, messaging WIC, MCH, Becoming a Mom, other * Home visits: infant health, home safety, family support * *Healthy Start work is aligned/team is actively partnering with Title V

31 Measures & Strategies cont Child Health NPM: Developmental screening (10 through 71 months) ESM: Percent of program providers using a parent-completed developmental screening tool during an infant or child visit NPM: Child Injury (0 through 9 years) ESM: Number of child safety seat inspections by certified technicians Developmental screening 1 month to Kindergarten age * Motor vehicle safety (car seats size and age appropriate) * Home safety (home visits and risk assessments) * Physical activity (home based child care and schools) Social-emotional development education (child care) *Healthy Start work is aligned/team is actively partnering with Title V

32 Measures & Strategies cont NPM: ESM: SPM: SPM: Cross-cutting / Life Course Smoking during Pregnancy and Household Smoking Percent of pregnant women program participants who smoke referred to the Tobacco Quitline and enrolled in services Number of safe Sleep (SIDS/SUID) trainings provided to professionals Percent of children living with parents receiving emotional support Safe sleep instructor training integrated/expanded community baby shower (safe sleep, smoking cessation, breastfeeding)* Smoking/tobacco screening, referral/toolkit; BABY & ME Tobacco Free * Oral health collaboration and preventive services Prepared providers (SHCN diversity, inclusion, integration) Care coordination and caregiver support/health *Healthy Start work is aligned/team is actively partnering with Title V

33

34 Kansas MCH Website

35

36 This image cannot currently be displayed. Kansas MCH Facebook Page

37

38 MEASURES BY DOMAIN Women & Maternal Health NPM 1: Well-woman visit (past year) ESM: ESM: Percent of infants born to pregnant women receiving prenatal care beginning in the first trimester. The percent of women receiving postpartum follow-up health care services within the first four to six weeks after delivery. Priority: Improve pre-conception, prenatal and postpartum health care services for women of child bearing age.

39 STRATEGIES The TEL-LINK program will continue to provide information and referrals for preconception, prenatal and postpartum care services. Home visiting programs will continue to encourage participants to obtain adequate preconception, prenatal, and postpartum health care services. The Department of Heath and Senior Services (DHSS) will continue to collaborate with the March of Dimes, Bootheel Babies & Families, FLOURISH St. Louis, and other prenatal care and infant wellness collaborates to support initiatives to reduce infant morbidity and mortality. Home Visiting Programs will educate home visitors on the process for timely Medicaid enrollment for pregnant women and re-distribute the document to LIAs via and at annual HV program conferences.

40 MEASURES BY DOMAIN Women & Maternal Health NPM 2: Low risk cesarean deliveries ESM: Improve maternal/newborn health by increasing the number of hospitals that implement the Alliance for Innovation on Maternal Health (AIM) bundle Safe Reduction of Primary Cesarean Births. Priority: Improve maternal/newborn health by reducing cesarean deliveries among low-risk first births.

41 STRATEGIES The Healthy Births and Babies Unit will continue to educate women of reproductive age on the benefits of a full term pregnancy through various social media (Text4baby) and by providing educational materials (brochures) through the Home Visiting Program. The Healthy Births and Babies Unit will educate women of reproductive age on the risks of a cesarean birth through various social media (Text4baby) and educational materials (brochures).

42 MEASURES BY DOMAIN Perinatal / Infant Health NPM 3: Perinatal regionalization ESM: Ensure risk appropriate care for high risk infants by increasing the number of Missouri birthing hospitals implementing the March of Dimes Preterm Labor Assessment Toolkit (PLAT) to reduce infant mortality/morbidity. Priority: Ensure risk appropriate care for high risk infants to reduce infant deaths.

43 STRATEGIES DHSS will continue to collaborate with local infant mortality initiatives (including the Kansas City and Bootheel Healthy Start grantees) on prevention measures and accessing prenatal care at the local level. The Healthy Births and Babies Unit will educate women of reproductive age on the benefits of 17P through various social media (Text4baby) and by distributing March of Dimes educational materials through the Home Visiting Program. DHSS will collaborate with the Missouri Hospital Association (MHA) to implement the Preterm Labor Assessment Toolkit (PLAT) in Missouri birthing hospitals.

44 Child Health NPM 6: Developmental screening MEASURES BY DOMAIN ESM: Increase the percentage of eligible enrolled children, ages 1 year through 3 years, receiving a developmental screening using a validated parentcompleted screening tool through Maternal, Infant and Early Childhood Home Visiting (MIECHV) and Healthy Families Missouri Home Visiting (HFMoHV) programs. Priority: Support adequate early childhood development and education.

45 STRATEGIES The DHSS early childhood home visiting program s Local Implementing Agencies (LIAs) will utilize Ages & Stages Questionnaire screenings to identify children s developmental needs and provide support to primary caregivers through developmental information and/or activities which will contribute to improved school readiness of enrolled children.

46 MEASURES BY DOMAIN Child Health and/or Adolescent Health NPM 7: ESM: ESM: Child Injury Increase the number of local public health agencies (LPHA) Child Care Health Consultants that are trained on Early Childhood Toolkits which will result in increased screening and referral for traumatic brain injury (TBI) in children ages 0 to 5. Number of schools that received training on evidence based suicide prevention programs Priority: Reduce intentional and unintentional injuries among children and adolescents.

47 MEASURES BY DOMAIN Children & Youth with Special Health Care Needs NPM 11: Medical Home ESM: Increase the percentage of families of newly enrolled Special Health Care Needs (SHCN) program participants who are aware of the importance of a medical home for children with and without special health care needs. Priority: Ensure coordinated, comprehensive and ongoing health care services for children with and without special health care needs.

48 MEASURES BY DOMAIN Cross-Cutting or Life Course NPM 14: Smoking during Pregnancy and Household Smoking ESM: The number of Missouri communities (cities, towns, etc.) with comprehensive smoke-free ordinances. ESM: Annual number of callers to the Missouri Quitline that are women of childbearing age. Priority: Prevent and reduce smoking among women of childbearing age and pregnant women and reduce childhood exposure to second hand smoke.

49 MEASURES BY DOMAIN Cross-Cutting or Life Course NPM 15: Adequate Insurance Coverage ESM: Percent of primary caregivers and children with health insurance at one year post enrollment among Missouri Home Visiting program participants. Priority: Ensure adequate insurance coverage and improve health care access for Maternal and Child Health (MCH) population.

50 STATE PRIORITY AREAS State Performance Measure (SPM) #1 : Breastfeeding Priority: Enhance breastfeeding initiation and duration rates among Missouri mothers. SPM #2: Safe Sleep Priority: Promote safe sleep practices among newborns to reduce sleep-related infant deaths. SPM #3: Oral Health Priority: Enhance access to oral health care services for MCH populations Oral Health. SPM #4: Physical Activity Priority: Reduce obesity among children and adolescents. SPM #5: Mental Health Priority: Improve access to mental health care services for MCH populations.

51 IM COIIN ACTIVITY NPM #3 Perinatal/Infant Health: Ensure risk appropriate care for high risk infants to reduce infant deaths. Strategies DHSS will continue to participate in the Infant Mortality Collaborative Improvement & Innovation Network (IM CoIIN) to learn best practices and strategies for implementing risk appropriate care in Missouri. FY16 The Section for Healthy Families and Youth participated in the IM CoIIN coordinated by National Initiative for Children's Healthcare Quality (NICHQ) and MCH. Participation included work and data submissions related to the learning networks of Risk Appropriate Care and Pre and Early Term Birth. Missouri was consistently named for having all our data submissions complete and on time to NICHQ. Missouri also shared our experience regarding risk appropriate care during one of the monthly risk appropriate care webinars facilitated by NICHQ. A challenge of the IM CoIIN is that best practices and strategies for implementing perinatal regionalization may work well in one state, but not necessarily in all states. Missouri is experiencing this challenge related to the difficulties faced with perinatal regionalization legislation efforts. We have been through three legislative sessions and have unsuccessfully passed the bill.

52 Nebraska Title V Program & Healthy Start Partnership Opportunities Healthy Start Regional meeting June 8-9, 2017

53 Selected NPMs* (8 of 15) NPM1: Well-woman visit NPM4: Breastfeeding (ever; exclusively 6 months) NPM5: Safe sleep position NPM7: Unintentional injury Child (0-9), Adolescent (10-19) NPM8: Physical activity NPM10: Adolescent well-visit (12-17) NPM11: Medical home NPM15: Adequate insurance * National Performance Measures

54 SPM1: Access to and adequacy of prenatal care SPM2: Infant abuse and neglect Selected SPMs* SPM3: Access to preventive and early intervention mental health services for children with and without special healthcare needs *State Performance Measures

55 Women/Maternal Health Measures & Strategies by Domain NPM: Well-woman visit (past year) ESM: Percent of Title X Family Planning female clients under 25 screened for chlamydia and gonorrhea infections as part of a comprehensive visit SPM: Access to and adequacy of prenatal care Well-woman visit (increase education and access) Preventive care visit after contraceptive/std visit Maternal Medical Home Minority women initiating prenatal care in first trimester

56 Perinatal/Infant Health NPM: Breastfeeding (ever breastfed; exclusively through 6 months) Measures & Strategies by Domain NPM: Safe sleep position ESM: Percent of infants whose sleep environments are assessed, at least once, by 6 months of age SPM: Infant abuse and neglect Increase # of Baby-Friendly hospital designations Minority women breastfeeding exclusively at 6 months Collaborate with MIECHV, licensed child-care providers, CFS, and birthing hospitals to increase use of safe sleep practices and policies Increase use of crying plans Increase maternal depression screening

57 Child Health NPM: Unintentional injury Child (0-9) Measures & Strategies by Domain NPM: Physical activity SPM: Access to preventive and early intervention mental health services for children with and without special healthcare needs Booster seat use by parents School participation in motor vehicle education for parents Community engagement on built environments to support active living Telehealth system usage for behavioral health services Children served in a medical home practice

58 Adolescent Health Measures & Strategies by Domain NPM: Unintentional injury Adolescent (10-19) ESM: Number of schools participating in Teen Driver Safety program NPM: Physical activity NPM: Adolescent well-visit (12-17) Child Safety CoIIN Teen Driver Safety Community engagement on built environments to support active living Increase school participation in referrals for sexual health services Nebraska Adolescent Health Advisory Committee strategic plan

59 Children/Youth with Special Health Care Needs Measures & Strategies by Domain NPM: Medical home SPM3: Access to preventive and early intervention mental health services for children with and without special healthcare needs Family engagement Children served in a medical home practice CYSHCN receive all the mental health care/counseling needed CYSHCN receive all age-appropriate social/emotional developmental screening

60 Cross-cutting/Life Course Measures & Strategies by Domain NPM: Adequate insurance CLAS standard/health literacy/trauma-informed care adoption by providers Community health worker engagement

61 Oklahoma Title V Program & Healthy Start Partnership Opportunities HEALTHY START REGIONAL MEETING JUNE 8, 2017

62 Selected NPMs* NPM1: Well-woman visit NPM4: Breastfeeding NPM5: Safe sleep NPM7: Child injury NPM9: Bullying NPM10: Adolescent well-visit NPM12: Transition NPM14: Smoking *National Performance Measures

63 Selected SPMs* SPM1: Infant Mortality SPM2: Maternal Mortality SPM3: Families Able to Access Services for their Child with Behavioral Health Needs *State Performance Measures

64 Measures & Strategies Women & Maternal Health NPM 1: Well-woman visit (past year) ESM: The number of health care providers utilizing a woman s health assessment tool SPM: Maternal mortality rate per 100,000 live births Priorities: Reduce the prevalence of chronic health conditions among childbearing age women; Reduce unplanned pregnancy Key Strategies Partner with home visitation programs to promote importance of well woman visits, prenatal care, and postpartum visits Partner with Medicaid agency to educate providers on unbundling of postpartum care visit and promote postpartum visits among women with recent deliveries Promote access to contraceptive services including long acting reversible contraceptives (LARC) Educate reproductive age males and females on being healthy before and between pregnancies (Tools: Women s Health Assessment Tool and One Key Question) Utilize Text4Baby messages regarding healthy moms and babies Utilize social workers in CHDs to address needs including maternal mood disorders

65 Measures & Strategies Perinatal & Infant Health NPM 4: Breastfeeding (ever breastfed; exclusively through 6 months) ESM: Percentage of births occurring in Oklahoma birthing hospitals that are designated as Baby-Friendly NPM 5: Percentage of infants placed to sleep on their back ESM: SPM: Percentage of infants delivered at hospitals participating in infant safe sleep/sleep sack program Infant mortality rate per 1000 births Priority: Reduce infant mortality; Reduce incidence of preterm and low birth weight births Key Strategies Continue Preparing for a Lifetime It s Everyone s Responsibility Infant Mortality Reduction Program Provide support and promote Oklahoma Breastfeeding Hotline, Hospital Breastfeeding Education Project, Becoming Baby Friendly in Oklahoma Project, and Oklahoma Mother s Milk Bank Project Increase Breastfeeding Friendly Worksites and partner with WIC to increase the number of ethnically diverse peer counselors. Continue Baby Café efforts for Native American/African American families Increase the number of hospitals participating in the Sleep Sack Program, along with organizations participating in Safe Sleep Cribs program with additional efforts to reduce racial disparities. Increase number of infant safe sleep trainings given to providers and professional organizations.

66 Measures & Strategies Child Health NPM 7: Child injury-related hospital admissions per population (0-19 years) ESM: Percentage of infants delivered at hospitals providing the Period of Purple Crying Abusive Head Trauma curriculum Priority: Reduce the incidence of unintentional injury among children Key Strategies Increase number of delivering hospitals participating in the Period of PURPLE Crying Abusive Head Trauma curriculum Support car seat program and car seat safety checks and installations Continue to support and promote the Poison Control Center

67 Measures & Strategies Adolescent Health NPM 10: Adolescent well-visit (12 through 17 years, past year) ESM: Number of adolescents trained on teen pregnancy prevention/positive youth development curriculum Priority: Reduce teen pregnancy Key Strategies Increase number of adolescents participating in evidence-based teen pregnancy prevention programs Continue to educate on most effective methods of contraception first Increase number of available trainers statewide who have completed a training of trainers in evidence-based teen pregnancy prevention curricula Increase number of Public Health Youth Councils across state

68 Measures & Strategies NPM 14: Smoking during Pregnancy ESM: Cross-cutting / Life Course Percentage of pregnant women who smoke who call the Oklahoma Tobacco Helpline for cessation support Priorities: Reduce infant mortality; reduce maternal mortality; reduce health disparities; improve mental health of the MCH population Key Strategies Encourage pregnant women to quit smoking through referral to the QUIT line Air public service announcements on smoking and pregnancy and the impact of secondhand smoke on infants. Effectively utilize tobacco cessation media messages to reach African American and Native American mothers. Explore data related to e-cigarette use among women of reproductive age and pregnant women to determine the impact these devices have on tobacco use and health

69 Oklahoma Resources

70 Thank You!