Program Team Accomplishments in 2008
By Lauren Raskin Ramos, MPH
Director of Programs
What a fruitful and exciting year for the AMCHP Program Team! Staff worked to strengthen alignment of programmatic work with members needs, share state success stories, build capacity in Title V agencies to address key topics in women’s, infant and adolescent health, and grow our programming in children and youth with special health care needs.
AMCHP completed work on three Action Learning Collaboratives to help states address healthy weight in women, address prenatal smoking cessation, and increase screening for intimate partner violence, moved work on science-based approaches to teen pregnancy, HIV, and STI prevention forward, completed an extensive assessment of state Title V agencies programs and functions and continuing education needs, launched Innovation Station - AMCHP’s state MCH Best Practices program, and provided MCH epidemiology skills building training to nearly 280 state and local MCH staff! AMCHP programs continue to benefit from collaboration with several important national partners as detailed below.
In 2009, look for enhanced programming and new resources in several areas, including a growing database of what’s working in MCH, the launch of the State Public Health Autism Resource Center, additional efforts to strengthen family involvement and leadership in AMCHP and Title V programs, an increased focus on workforce and leadership development for state MCH professionals, identification of innovative strategies to address racism and infant mortality, and a new partnership with the state and local MCH Epidemiology professional group. The following section highlights some of the major programmatic activities of 2008 and provides a preview of what’s to come in 2009.
Program Team Accomplishments in 2008
WOMEN’S AND INFANT HEALTH PROGRAM
• Eliminating Racial Inequities in Infant Mortality
AMCHP, CityMatCH, and the National Healthy Start Association (NHSA) — with funding from the W.K. Kellogg Foundation — launched the Partnership to Eliminate Disparities in Infant Mortality to eliminate racial inequities contributing to infant mortality within U.S. urban areas. The first activity of the partnership is an 18-month long Action Learning Collaborative (ALC). The following six teams were selected through a competitive process to participate in the ALC: Los Angeles, California; Aurora, Colorado; Pinellas County, Florida; Chicago, Illinois; Columbus, Ohio; and Milwaukee, Wisconsin.
The emphasis of this ALC is on innovative approaches to reducing racial inequities in infant mortality in urban communities, with particular attention paid to the impact of racism. Teams will be combining their knowledge of evidence-based practices with local knowledge and problem solving, to move beyond what has typically been done to address infant mortality. For additional information contact Jessica Hawkins.
• Promoting Health in Women of Reproductive Age
As part of our Women’s Health Partnership, AMCHP and CityMatCH convened the final meeting for the Healthy Women of Reproductive Age Action Learning Collaborative in March 2008. The Women’s Health Partnership was formed in the spring of 2005 to build state and local capacity to promote safe motherhood and enhance women's health before, during and after pregnancy. Our final report, Promoting a Healthy Weight in Women of Reproductive Age: Experiences & Lessons Learned from Eight State/Local Health Department Teams, details the experiences and lessons learned from the ALC. The eight participating teams were given the task of developing strategies aimed at promoting a healthy weight in women of reproductive age in their communities and states. The report was designed to inform other communities and states across the nation that are interested in addressing overweight and obesity among the women they serve, to improve pregnancy and birth outcomes. For additional information or to request a copy of the report, contact Stacey Cunningham.
• Strengthening State Health and Education Agency Partnerships to Improve HIV, STD and Unintended Teen Pregnancy Prevention
In early 2008, the National Stakeholders Collaborative (NSC), made up the Association of Maternal & Child Health Programs, National Alliance of State & Territorial AIDS Directors, National Coalition of STD Directors, Society of State Directors of Health, Physical Education & Recreation, hosted the 2008 National Stakeholders Meeting (NSM) — a two day capacity building process with nine months of follow-up technical assistance for state teams made of NSC memberships. The main objective of the NSM was to increase communication and collaboration between state health and state education agencies in order to develop a shared vision for supporting and improving HIV, STD and teen pregnancy prevention for school-aged youth, and expanding the base of support for developing effective policies and programs. At the 2008 NSM, state teams from Alaska, Arizona, Kentucky and Massachusetts came together to engage in professional development, expand and develop strategic partnerships, and create an action plan for improving HIV, STD and teen pregnancy prevention efforts in their states. Since 2003, 33 states have participated in an NSM. In the evaluation of past participants, nearly all respondents reported the NSC strengthened communication and collaboration between state health and education agencies to support and improve HIV, STD and pregnancy prevention for school-aged youth. NSC activities, including NSMs, are supported through cooperative agreements with the Centers for Disease Control and Prevention, Division of Adolescent and School Health (CDC-DASH). For additional information, contact Lissa Pressfield.
• Understanding Adolescent Reproductive and Sexual Health Disparities
Significant disparities exist in adolescent pregnancy, birth, STD and HIV rates. Addressing adolescent health, specifically, sexual and reproductive health issues can contribute to reduction in teen pregnancy, birth sexually transmitted diseases and HIV. Many states have taken action by addressing adolescent reproductive and sexual health (ARSH) in state maternal and child health efforts, yet many states continue to struggle with reducing inequitable adolescent reproductive health outcomes.
AMCHP is developing strategies to address our future work in health equity, specifically ARSH. Beginning with an assessment of state Title V programmatic work and capacity needs related to ARSH disparities, this effort examined the attention given to ARSH disparities, gathering information about state-level efforts planned or underway and examining capacity needs of AMCHP members around this important issue. The member assessment revealed that racial/ethnic, income and rural/urban disparities are a top concern for AMCHP members. Capacity-building support needs identified by states included structural resources, data and information systems, organizational relationships and competencies and skills. AMCHP is currently following up with a subset of states to gather more in-depth information about their efforts and capacity building supports needed to develop and/or sustain these efforts. In 2009, AMCHP will convene an advisory group of members and adolescent health partners to consider assessment results and develop strategies to meet states’ needs. For additional information, contact Sharron Corle.
• Promoting Evidence-based Approaches to Teen Pregnancy, HIV and STI Prevention
The prevention of teen pregnancies, births and HIV and STIs remains a major challenge for public health practitioners in the United States. Lack of information on evidence-based programs, scarce resources and the absence of connection between state and local practitioners have all been cited as barriers to implementing new approaches to teen pregnancy and HIV and STI prevention. For the past two years, AMCHP has been working to build state, local, community-level capacity to implement evidence-based approaches to teen pregnancy, HIV and STI prevention.
In 2007, AMCHP in partnership with CityMatCH, conducted a two-day training, Science-Based Approaches to Teen Pregnancy Prevention; What Are They and How Can We Promote Their Use?, with state, local and community-level teams from Arizona, Kansas, Montana, Nebraska, North Carolina, Ohio, Pennsylvania, Tennessee and Washington. AMCHP and CityMatCH provided support and technical assistance to the teams through 2008. Evaluation of the 2007 training demonstrated that the project met two out of three of the original goals of the training — disseminating the work of CDC and their grantees in the area of science-based approaches to teen pregnancy prevention and increasing the collaboration between and among state and local representatives working on teen pregnancy prevention. It is too early to assess the third goal, improving overall state and local efforts to reduce teen pregnancy.
In 2008, AMCHP in partnership with the National Association of County & City Health Officials (NACCHO), conducted a three-day training, Moving from Interest to Action: Evidence-Based Approaches to Teen Pregnancy and HIV/STI Prevention, with state, local and community-level teams from Colorado, Maine, Minnesota, Missouri and South Carolina. AMCHP and NACCHO will be working with the teams through 2009. For additional information, contact Sharron Corle.
DATA AND ASSESSMENT
• Providing Training and Epidemiology Skills-building for MCH Professionals
In 2008, AMCHP conducted six MCH epidemiology skill building trainings in partnership with the CDC’s Division of Reproductive Health, and the Maternal and Child Health Bureau. AMCHP hosted four training workshops prior to the 2008 MCH Epidemiology Conference in December and two Data Skills Building Sessions at the AMCHP Annual conference. The trainings focused on enhancing partnerships and developing a common set of data skills for MCH data professionals and the state data program staff. Nearly 270 state and local MCH staff were trained.
AMCHP also sponsored a plenary at the conference on Translating Data into Action: Advancing MCH Evidence Based Public Health Programs and Policies. The plenary discussed translating data into action and highlighted examples of two state agencies and a local public health agency (Oregon, Michigan, and Los Angeles County public health) that have used data results to inform and drive policy, programs and delivery systems.
The four two-day MCH Epidemiology data training topics included: MCH Block Grant Needs Assessment, Population Attributable Fraction, Scientific Writing, Time-Trend Analysis, Data Records Linkage and Geographic Information System (GIS). National and state MCH data professionals participated in the trainings and were led by seasoned MCH epidemiology experts. At the completion of the trainings, the participants indicated increase in knowledge on the training topics.
AMCHP also awarded seven data mini-grants to selected state MCH teams — Oregon, Pennsylvania, Michigan, Massachusetts, Washington and the Urban Indian Health Institute (UIHI) — to coordinate and conduct internal capacity-building activities in data and assessment, and two data mini-grants to states (Massachusetts and Oregon) to focus on adolescent reproductive health data. For additional information, contact Henry Maingi.
• AMCHP Launches Innovation Station
This fall, AMCHP launched the Innovation Station, a growing database of promising Best Practices in Maternal and Child Health from around the country. Innovation Station is intended to be a mechanism to share what programs are working in MCH, to contribute to program replication, assure implementation of sustainable evidence-based systems for MCH, provide a central, easily accessible resource of effective MCH programs, and provide a means for peer to peer technical assistance. AMCHP received several new Best Practices submissions from states. AMCHP convened a Best Practices Review Panel, composed of AMCHP members, partners and other experts in the public health field to review new submissions. Best Practices submissions will be accepted on a rolling basis, and awards will be given to top submissions at the AMCHP Annual Conference. For more information, contact Darlisha Williams.
WORKFORCE AND LEADERSHIP DEVELOPMENT
• Title V Workforce Development Survey
Between May and August 2008, AMCHP fielded the Workforce Development Survey to gain a national profile of the state programs’ components and functions, and identify priority training needs and preferred strategies and challenges. All 50 states and the District of Columbia provided at least one program response; of these, 49 MCH (96%) and 44 CYSHCN (86%) programs completed the survey. Four of the eight U.S. territories completed the survey. Using preliminary data results, three reports have been developed: 1) State Title V Workforce Development Survey Program Profiles Preliminary Findings, 2) State Title V Workforce Development Survey Training Needs, Professional Development, and Graduate Education Strategies Preliminary Findings, and 3) State Title V Workforce Development Survey Training Needs and Professional Development Strategies Preliminary Findings. To download the documents, visit AMCHP’s website. Further analysis will continue in 2009, and additional reports and manuscripts will be developed, including profiles for each state. For additional information, contact Librada Estrada.
• New Director Mentor Program (NDMP)
In 2008, seven states (Colorado, Delaware, Florida, Maine, Oregon, Rhode Island and Utah) participated in the New Director Mentor Program (NDMP) either as a New Director (four) or as a Mentor (three). Each of these relationships will continue through 2009. The New Director-Mentor relationship among Colorado, Maine and Utah has developed into a learning collaborative focusing on community systems building. Since meeting first in August 2008, the collaborative has held monthly calls to share ideas, resources and processes with each other. Representatives from each state in the collaborative and Champions, Inc will be presenting on their partnership to date at the 2009 AMCHP Annual Conference, Title V CYSHCN Program Evolution: Achieving a Community-Based System of Services by 2010.
AMCHP worked to grow the NDMP, by streamlining the application process, improving outreach to new directors, and strengthening the evaluation component. Internal policies, procedures and forms continue to be updated. AMCHP continues to follow up with new directors to inform them of the NDMP and to encourage participation. To assure consistency between workforce programs, the applications for the NDMP have been updated to reflect the functions listed in the Title V Workforce Development Survey. For additional information, contact Librada Estrada.
• Supporting Family Involvement and Leadership
In 2008, AMCHP supported 10 scholars from Arkansas, Connecticut, Massachusetts, Michigan, New York, North Carolina, Oklahoma, South Carolina, Texas and Washington and five mentors to attend the AMCHP Annual Conference. Family Scholars and mentors participated as session presenters, networked with state Title V staff, parent professionals and other families, visited Congressional or Senate members on Capitol Hill, and provided input on program activities. Family Scholars and mentors gained a deeper understanding of Title V programs, as well as national MCH and CYSCHN issues.
A Look Ahead: AMCHP Program Team in 2009
WOMEN’S AND INFANT HEALTH PROGRAM
• Developing Resources on Women’s Preventive Health
As part of the Women’s Health Partnership, AMCHP will continue to partner with CityMatCH to address the issue of healthy weight among women of reproductive age. In 2009, the Women’s Healthy Partnership will support and provide technical assistance to the eight state teams who have been creating resources and implementing projects as part of the Health Weight for Women of Reproductive Age Action Learning Collaborative over the last two years and translate lessons learned and create tools for all states to help with program replication. The Women’s Health Partnership will also develop a series of issue briefs based on the five priority areas included in the Women’s Health Framework: Injury and Chronic Conditions, Health Disparities, Reproductive and Maternal Health, Healthy Lifestyles, and Access and Financing. For additional information, contact Sara Fahey.
• Creating State Tools on Smoking Cessation
As part of the Smoking Cessation for Women of Reproductive Age Initiative, AMCHP along with the American College of Obstetricians and Gynecologists (ACOG) and the Planned Parenthood Federation of America (PPFA) will create a comprehensive toolkit that will serve as a framework to assist states interested in creating collaborations similar to this one. The goal of the toolkit is to provide states with resources, examples, models and recommendations to increase provider referral to the state tobacco Quitlines and encourage providers to discuss tobacco use with their clients. In addition, the project will evaluate the overall Initiative which included an Action Learning Collaborative launched in 2005 and two sets of state mini-grant projects launched in 2006 and 2007. This evaluation will assess the projects and outcomes of the 13 states that have participated in this initiative as well as the partnership’s ability to build state capacity around smoking cessation programs for women of reproductive age. For additional information, contact Stacey Cunningham.
ADOLESCENT HEALTH PROGRAMS & WOMEN’S AND INFANT HEALTH PROGRAM
• Focusing on Preconception Care and Adolescent Women Initiative
AMCHP’s Women’s and Adolescent Health Programs are collaborating on a two-year initiative that will explore the integration of preconception health into state-level adolescent health efforts and support AMCHP’s lifespan approach to women’s health. AMCHP will work with a small practice collaborative that will consider how states can create, implement and evaluate preconception care efforts with adolescent women. The practice collaborative will consist of four demonstration sites, each composed of four team members that would include an Adolescent Health Coordinator, Maternal and Child Health Director, Family Planning or Title X representative and one other representative (i.e. WIC Coordinator or School-Based Health Coordinator). Demonstration sites will be selected through a Request for Proposal (RFP) process. Teams will be tasked with focusing on several of the 10 CDC Recommendations for Preconception Health — Individual Responsibility across the Lifespan; Consumer Awareness; Interventions for Identified Risks; and Public Health Programs and Strategies and Health Care — to determine how they will integrate preconception care into current adolescent health efforts. Within the next several months AMCHP will convene a small advisory group to provide assistance with developing the RFP and fine tuning the project plan. For additional information, contact Sharron Corle
ADOLESCENT HEALTH PROGRAMS
• Revisiting, Recharging, and Renewing State Health and Education Agency Partnerships to Improve HIV, STD and Unintended Teen Pregnancy Prevention for School-Aged Youth
The National Stakeholders Collaborative (NSC), made up the Association of Maternal & Child Health Programs, National Alliance of State & Territorial AIDS Directors, National Coalition of STD Directors, Society of State Directors of Health, Physical Education & Recreation, will be hosting the first ever National Stakeholders Meeting Reconvene (NSM-R) in January 2009. The NSM-R will bring teams that participated in 2003 and 2005 NSMs back together to take current collaborative efforts around HIV, STD, and teen pregnancy prevention for school aged youth to the next level. The Reconvene is a three day capacity building process with twelve months of follow-up technical assistance. On January 12-15, 2009, teams from California, Kansas, Missouri, and Michigan will participate in needs-based workshops and action planning activities aimed at enhancing knowledge, skills, and collaboration. The NSM-R is supported though cooperative agreements with the Centers for Disease Control and Prevention, Division of Adolescent and School Health (CDC-DASH). For additional information, contact Lissa Pressfield.
• Supporting State Efforts to Implement Autism Plans
AMCHP is launching the State Public Health Autism Resource Center (SPHARC) to provide a central site for states to learn about state autism activities and resources, share promising practices, link to federal and national partners, and follow the Combating Autism Awareness Initiative activities. SPHARC will serve as a means to facilitate communication among states to learn from successes and challenges as states develop state autism plans and work to strengthen services for children, youth and families with autism spectrum disorders and other developmental disabilities. SPHARC will also serve as a technical assistance site to the six MCHB-funded state autism implementation grants, providing a shared workspace and listserv for those states. AMCHP will highlight the work of the six implementation grantees on an ongoing basis, creating resources for all states to learn from the experience of the implementation states. For additional information or to share ideas about SPAHRC, please contact Lauren Raskin Ramos.
WORKFORCE AND LEADERSHIP DEVELOPMENT
• Providing Leadership training to Title V Programs
To continue to improve and strengthen New Director Mentor Program (NDMP) delivery, AMCHP will develop a curriculum for New Directors linked to the MCH leadership competencies to provide additional support and resources for new directors as well as a means to create a peer network for new directors. AMCHP will continue to provide technical assistance to the states that are currently participating in the NDMP and to those states interested in engaging in the program. AMCHP will also collaborate with the recipient of the MCH Leadership in Public health Program to develop leadership and continuing education to management staff in Title V programs. For additional information, contact Librada Estrada.
• Strengthening Family Involvement in Title V
The AMCHP Family & Youth Leadership Committee (FYLC) is developing three products in 2009 to assist states and AMCHP to better support family involvement in Title V programs. The three products are:
• Family Delegate (FD) Profile—this document will outline the potential role of a FD and can be a tool for states to recruit individuals into this position. The purpose is to inform the potential candidate of possible responsibilities, support and resources that might be available from the state and to serve as a recruitment document.
• AMCHP Recommendations—this product will provide recommendations for what AMCHP as an organization should consider doing to train and enhance the competency of Family Delegates and increase family involvement.
• Family Involvement Issue Brief—this product will highlight five states that successfully engage family delegates in Title V work. The issue brief will feature the family involvement programs in Colorado, Missouri, New Hampshire, New York and Washington.
For additional information, contact Librada Estrada.
DATA AND ASSESSMENT
• Working with State MCH Epidemiology Group
AMCHP is pleased to increase work with the new State and Local MCH Epidemiology Professional Group. AMCHP will support this group in their efforts to more formally organize and develop the network. Specifically, AMCHP will assist with communication efforts by providing a shared virtual workspace for the group and hosting regular conference calls. AMCHP looks forward to this new relationship and to increased involvement of state MCH epidemiologists in our work.