Program Updates

AMCHP Program Team Accomplishments in 2010

By Lauren Raskin Ramos, MPH
Director of Programs, AMCHP

This Annual Year in Review issue of Pulse provides an opportunity for the Program Team to reflect on our work from the previous year and highlight key achievements with you. It also allows us to share our excitement with you around new initiatives that are planned for 2011.  

Over the past year, the Program Team continued to move toward a life course approach to our work, working outside of our own project silos to bridge efforts across the MCH “age ranges” and “functions” through which we are funded, to produce resources, trainings and technical assistance activities that target MCH across the lifespan. We are looking forward to furthering that work in 2011, and learning from you about how we can also best support Title V efforts to implement a life course perspective.  

As the accompanying chart shows, 2010 sure was a productive year. The Program Team produced virtual learning activities accessed by over 3,500 individuals, created 11 publications, including two peer reviewed journal articles, provided training for more than 500 individuals, delivered 13 presentations at national conferences, collected three new best practices in our Innovation Station, supported 10 grants to states, and provided six targeted technical assistance site visits and calls -- all on critical MCH issues.   

As a Program Team, we pursued new approaches to training and distance learning, maintained collaborative work with key partners CityMatCH and Family Voices, and strengthened partnerships with national organizations such as the Association of SIDS and Infant Mortality Programs and the Autism Society of America. New funding and opportunities allowed us to expand our staffing and efforts in Children and Youth with Special Health Care Needs (CYSHCN) and MCH Epidemiology in particular. 

While additional details follow, a few Program highlights include supporting innovative ways to help states address the CDC’s preconception health and health care recommendations, launching a new collaborative with the National Association of Chronic Disease Directors to support partnerships between MCH and chronic disease around gestational diabetes, creating a peer to peer exchange for state Combating Autism Awareness Initiative grantees, and convening great thinkers around adolescent reproductive and sexual health disparities. The Program Team also provided comprehensive technical assistance to Title V programs through site visits and teleconferences tailored to specific state needs, ranging from science-based approaches to teen pregnancy prevention to state waivers for autism, and worked to respond to emerging issues and hot topics, such as convening states to talk about approaches to the needs assessment, and how to assure a focus on special populations in H1N1 preparedness and response.  

2010 also marked the launch of new and improved leadership development programs through the revised New Director Mentor Program and the expanded Family Scholars Program. In addition to supporting Title V workforce and leadership development, we focused on our own leadership development, and participated as a Team in the MCH Leadership Skills Development Series.  

In the year ahead, AMCHP is anticipating implementing several new MCH initiatives, including supporting state efforts to measure preconception health investments, increasing partnerships to advance a comprehensive approach to adolescent health, producing new tools to help states investigate infant mortality, enhancing our focus on family participation, and completing a policy framework to support state comprehensive systems of care for children and youth with autism spectrum disorders and other developmental disabilities. AMCHP will continue efforts to support state workforce and leadership development through recruitment and support of new classes of New Directors and Family Scholars. We look forward to working closely with states and partners to support state efforts to understand and implement a life course perspective, and to continue to promote effective practices around preconception health and health care. And we continue to need your help to grow our Innovation Station (best practices) Initiative. 

New projects and funding will also allow us to recruit for new AMCHP staff to better support state Title V programs. Look for our new staff that will focus on child health (including injury prevention, oral health and mental health) and family participation both within AMCHP and in Title V programs. 

2011 will also bear the first fruits of a multi-year effort to create and implement AMCHP’s Evaluation and Assessment Program which will allow us to collect and analyze evaluation results on four core evaluation measures that we will use in all of our activities. We are looking forward to sharing those aggregate results with you! We are also excited about our effort to align all upcoming trainings, virtual learning opportunities and meetings with the MCH core competencies.  

As a Program Team we want to ensure our work is increasing your knowledge of critical MCH issues; that our trainings and other activities are useful to your program; that you can apply information from our activities to your work; and that you are satisfied with the AMCHP activities that you participate in and with the resources we produce. Stay tuned for these exciting new initiatives in 2011. And let us know what you think!  


Adolescent Health

The AMCHP Adolescent Reproductive & Sexual Health (ARSH) Disparities Summit provided an opportunity to bring together key MCH leaders, adolescent health partners, and others to explore the issue of adolescent reproductive and sexual health disparities and strategize about how state MCH programs can work more effectively on this issue. Four Scholars from Alaska, Texas, Puerto Rico and Washington were selected and sponsored to participate in the Summit and work with AMCHP staff during the year following the Summit to develop projects addressing a key ARSH disparities issue in their state. As part of this project, Alaska has been working with teachers and youth in alternative schools to improve health education and actively engage them in prevention activities. Texas has made huge strides in assessing the extreme ARSH disparities among foster care youth in the state by linking birth outcome data to child protective services records. Washington is looking at developing an overall statewide sexual health plan that addresses the issues of disparities and provides strategies to improve the sexual health of all youth. 


The National Stakeholders Collaborative (NSC) is a partnership between AMCHP, the
National Alliance of State and Territorial AIDS Directors (NASTAD), the National Coalition of STD Directors (NCSD), and the Society of State Leaders of Health and Physical Education (the Society) to build state-level, inter-agency partnerships, involving officials of departments of health and education, to develop joint strategies and implement effective programs and policies to prevent HIV/AIDS, sexually transmitted diseases (STDs), and unintended pregnancies among school-aged youth. Since 2003, 33 states have participated in a National Stakeholders Meeting (NSM). In 2010, the NSC responded to the state travel restrictions and the need to continue to re-energize the collaborative efforts developed through the project and launched the NSM 2.0 process with North Dakota and Texas. The NSC conducted on-site meetings to help the state teams develop inter-agency initiatives and will work with the teams for 12 months to support the implementation of their plans to improve programs and policies related to youth sexual health. As part of this project, North Dakota has been working to build stronger relationships with the American Indian communities in the state to assess their needs and support their efforts to improve sexual and reproductive health among youth. The Texas team has been working to integrate and raise awareness about the youth development framework and successfully added new youth development questions to their statewide Youth Risk Behavior Survey.  


Since 2009, AMCHP’s Adolescent and Women’s and Infant Health Teams have been working in partnership with the Association of State and Territorial Health Officials (ASTHO) to design strategies to bridge the gap between women’s and adolescent preventive health efforts. Initial efforts of the partnership focused on expanding preconception health efforts to include adolescent and young adult women through a Preconception Health and Adolescents Action Learning Collaborative (PHA ALC). The overall goal of the PHA ALC was to work with interested state maternal and child health programs and relevant partners to create strategies that focused on wellness across the lifespan. AMCHP and ASTHO are currently working with six state teams from Missouri, Ohio, Oregon, Pennsylvania, South Carolina and Utah to implement innovative strategies that integrate the CDC Preconception Care Guidelines into adolescent and young adult health and education initiatives.
Is it possible to integrate preconception health concepts into state-level adolescent and young adult efforts? The answer is YES! The six PHA ALC states have been successful in integrating preconception health concepts into their adolescent and young adult health efforts through such cutting edge strategies as creating and disseminating a reproductive life planning tool for adolescents; revising a Family and Consumer Science and health class curriculum to include preconception health topics; integrating preconception health concepts into the state department of education core health curriculum; and developing a model policy for integrating youth with disabilities in preconception health efforts.  

 

Best Practices

AMCHP continued to make progress toward the goal of becoming a central resource for state Title V programs on “what’s working” in MCH. Through the Best Practices database, Innovation Station, AMCHP collected a total of 32 practices from across the United States covering diverse topics and populations, from infant mortality reduction, to injury prevention, to transition for CYSHCN, and promoting preconception health. Innovation Station, an online, searchable database of emerging, promising and best practices continues to grow. Another key achievement in 2010 included highlighting promising practices during AMCHP’s Annual Conference by bestowing Best Practice awards to Alaska, Oregon and Rhode Island. AMCHP continues to seek submissions from innovative and promising programs throughout the year.  

 

Children and Youth with Special Health Care Needs

AMCHP’s State Public Health Autism Resource Center (SPHARC) sponsored a variety of key activities to build systems capacity for children and youth with Autism Spectrum Disorders (ASDs) and other developmental disabilities and to encourage state-to-state mentoring and information exchange. 2010 marked the beginning of several new and/or enhanced initiatives to meet the needs of state autism grantees through topical calls and technical assistance. Among the major activities completed in 2010 include an enhanced SPHARC website which was strengthened to better meet state needs. New features are an Expert’s Corner blog, Autism in the News section, Peer-to-Peer Exchange webpage, three new State Spotlights, updated Technical Assistance Call archive, state pages featuring information about State Autism Implementation Grantees, and updated resources for providers and families. AMCHP launched a Peer-to-Peer Exchange Program as a mechanism for state autism grantees to learn from one another about the system of care for children and youth with ASDs, share lessons learned and best practices, and develop action steps. In addition to topical planning calls, states have the opportunity to participate in an on-site meeting hosted by the Peer Leader state. To date, AMCHP has convened two Peer-to-Peer Exchanges: the first, in Missouri, focused on transitions; the second, in Alaska, focused on screening and partnerships. A third, hosted by Utah, focusing on medical home, began in late 2010. Participants rated the program very highly for content and relevance.  

AMCHP worked closely with leaders from MCHB’s Division of Children with Special Health Care Needs to organize CYSHCN Envision 2020 Planning Meeting, a strategic planning meeting to chart out the next 10 years for the Division. Over 100 CYSHCN leaders representing families, Title V programs national centers, universities, providers and other key stakeholders attended the October meeting.  

With support from the CDC’s National Center on Birth Defects and Developmental Disabilities, AMCHP developed the Act Early State Systems Grant Program to award grants of $15,000 to support the collaboration of Act Early Learn the Signs summit teams, and to further the activities initiated by state teams during the Act Early Summits to strengthen state and community systems for early identification and intervention for children with signs of ASD and other DDs. Twenty-two states applied and 10 states were recently awarded grants. AMCHP will support the grantees through conference calls and technical assistance.

 

MCH Epidemiology

In 2010, AMCHP continued to provide training and MCH Epidemiology skills-building for MCH professionals through five MCH epidemiology skill building trainings in partnership with the CDC’s Division of Reproductive Health and MCHB. AMCHP hosted three training workshops prior to the 2010 MCH Epidemiology Conference in December and two Data Skills Building Sessions at the AMCHP Annual Conference. The trainings focused on improving leadership skills and developing a common set of data skills for MCH data professionals and the state data program staff. Over 100 federal, state and local MCH staff was trained. Training topics included Practical Approaches to State MCH Data Records Linkage Practice; Getting the Word out: Writing Effective Abstracts, Manuscripts and MCH EPI Issues Briefs; Concentration in Basic Geospatial Methods (GIS) for Public Health Professionals training; Applied Multi-Level Modeling; Leadership training for MCH professionals. AMCHP will continue to offer exciting opportunities for training and professional development to the MCH community.  

AMCHP increased efforts to support the newly formed State & Local MCH Epidemiology Professional Group by providing resources to assist in communication, such as funding conference calls and creating a collaborative workplace using SharePoint. This group, with the support of AMCHP and the Council of State and Territorial Epidemiologists (CSTE), is working to strengthen MCH epidemiology at the state and local levels and to strengthen and improve the health outcomes of MCH populations.  

AMCHP completed a comprehensive retrospective evaluation of over five years of skills-building trainings offered at the MCH Epidemiology and AMCHP Annual Conferences to assess their applicability, knowledge/skills learned, expectations, satisfaction, usefulness, challenges/barriers and future suggestions for improvement. Overall, the evaluation results showed that the AMCHP/MCH EPI skills building workshops enhanced state Title V data program staff capacity in translating MCH data into action to inform programs and policy. Most participants were able to apply knowledge and skills learned in the trainings to their work, and share the new information and skills with their colleagues. 
 

Family Involvement

AMCHP’s Family Scholars Program continued to grow in 2010. AMCHP supported 11 scholars from Colorado, Connecticut, Georgia, Iowa, Indiana, Massachusetts, New Jersey, Oregon, Rhode Island, Vermont, and Wisconsin and three mentors from Maine, Minnesota, and Washington to participate in the AMCHP Annual Conference. During the Annual Conference, Family Scholars and Mentors participated in several sessions, networked with state Title V staff, parent professionals and other families, visited legislators and aides on Capitol Hill, and provided input on program activities. In addition, AMCHP expanded the Family Scholars Program to a year-long program that consists of a 12 month curriculum to provide additional leadership skills development to Family Scholars centered on seven of the MCH Leadership Competencies. Each month scholars and mentors connected virtually through conference calls, e-mails or webinars on such topics as writing your leadership story, different levels of family leadership development, the 75th Anniversary of Title V and other related topics. Through their participation, the Family Scholars increased their understanding of Title V, visited elected officials on Capitol Hill, expanded their professional network and grew as family leaders by expanding their current roles within the state and/or AMCHP.  

In summer 2010, Ryan Colburn, son of Alabama family leader Susan Colburn, passed away. To honor his memory, AMCHP established the Ryan Colburn Scholarship Fund to support a youth leader with special health care needs to attend the AMCHP Annual Conference. Over the last year funds for this event have been raised through individual donations and events held in Ryan’s hometown.  

AMCHP released an issue brief developed in conjunction with the Family & Youth Leadership Committee, AMCHP Issue Brief: State Profiles in Comprehensive Family Participation that explores family participation within state Title V MCH and CYSHCN programs, focusing on differing methods employed by six states: Colorado, Missouri, New Hampshire, New York, Oregon and Washington. The insights, successes and challenges provided by these states are meant to serve as examples for involving families in state Title V MCH and CYSHCN programs.

 

Women’s and Infant Health

In 2010, AMCHP partnered with the Association of SIDS and Infant Mortality Programs (ASIP) on a series of webinars to strengthen SIDS, SUID, Infant Safe Sleep initiatives across the United States. These quarterly webinars provided participants with current information, data, resources and tools regarding SIDS, SUID, Infant Safe Sleep and bereavement initiatives at the state and local level. National experts presented on a variety of topics including: Sudden Unexpected Infant Death (SUID): Research, Success and Challenges; New Research into Sudden Infant Death: Unraveling the Mystery of SIDS; Opportunities in Health Reform to Prevent Infant Death; and Addressing Racial Disparities in Infant Sleep Practice: New Perspectives and Recommendations. The cumulative participation in these webinars was over 2,000 individuals! Each webinar was recorded and the archive for the AMCHP/ASIP calls can be found on AMCHP’s website.  

AMCHP is currently partnering with the CDC’s Division of Reproductive Health and the National Association of Chronic Disease Directors (NACDD) to pilot a project with three states (MO, OH, WV) using an Action Learning Collaborative (ALC) model to support collaboration and integration between MCH and chronic disease programs for early prevention of chronic diseases with a focus on gestational diabetes. These cross-disciplinary teams include representation from the state MCH program, state chronic disease program, state diabetes programs and other health professionals. Activities in the MCH and Chronic Disease Collaborative have included a workshop with the three states, providing technical assistance and mentoring to state teams, facilitating a peer to peer network among state teams to learn from one another and conducting comprehensive evaluation of this effort through baseline and follow up assessments.  

AMCHP also promoted MCH authoring and partnering on two peer review journal articles. AMCHP collaborated with CDC’s Division of Reproductive Health and MCHB to author “Assessment of State Measures of Risk-Appropriate Care for Very Low Birth Weight Infants and Recommendations for Enhancing Regionalized State Systems, which is forthcoming in the Maternal and Child Health Journal and AMCHP also published “The State Maternal and Child Health/Title Agencies Support Breastfeeding: Surveillance and Programs” in the Journal of Breastfeeding Medicine Journal.
 

Workforce and Leadership Development 

AMCHP launched a revised New Director Mentor Program to provide a competency based leadership development mentor program for new Title V/MCH/CYSHCN Directors and senior direct reports. The revised program contains 12 self-directed modules based on the 12 MCH Leadership Competencies and a mentoring relationship to foster individual leadership development. Ten New Directors were accepted into the inaugural 2011 class and 10 seasoned Title V Directors have agreed to participate as their mentors.  

AMCHP continued to be an active partner in the Maternal and Child Health Public Health Leadership Institute, contributing to the development and marketing of the executive-education program to develop mid and senior level leaders serving MCH populations. Led by the University of North Carolina at Chapel Hill, AMCHP’s role in particular has been to assure that Title V needs, challenges and resources are represented in the examples and materials of the program. 

In 2010, the Workforce and Leadership Development Committee adopted a formal definition for MCH Leadership. Originally based on the definition for leadership from the MCH Leadership Competencies the following definition was adapted: An MCH Leader inspires and brings people together to achieve sustainable results to improve the lives of the MCH population. (See the full definition here.)

 

Program Team Activites and Resources in 2010

AMCHP’s Program Team supports a number of strategic objectives, including Goal #2: “Improve MCH outcomes by promoting a life course perspective and sharing effective and promising practices with state and territorial MCH programs,” and Goal #3, “State and territorial MCH programs will have a diverse and effective workforce with competent leaders at the national, state and local levels”.  Through funding from MCHB and the CDC, and in close collaboration with partner organizations, in 2010 the Program Team produced virtual learning activities accessed by over 3,500 individuals, created 11 publications, provided training for more than 500 individuals, delivered 13 presentations at national conferences,  supported 10 grants to states, and provided 6 targeted technical assistance site visits and calls.

 

Virtual Learning Activities (Over 3,500 participants)

·         Evaluating collaborative/programmatic efforts

·         Collaboration between State Health Agencies and State Education Agencies: How do you build commitment and buy-in?

·         Collaboration between State Health Agencies and State Education Agencies: Working Together to Improve School Sexual Health Programs for Youth

·         Strategies for Addressing the Sexual Health Needs of Youth in Foster Care

·         Teens in Title V: Models for Addressing Adolescent Health in State Maternal & Child Health Programs

·         Positive Youth Development

·         Practical Applications for State Health and Education Agencies

·         PREP and Abstinence Education Listening Session

·         Financing of Care for Children and Youth with Autism Spectrum Disorders and Other Developmental Disabilities

·         Transition for Children and Youth with Autism Spectrum Disorders Other Developmental Disabilities

·         Impact of Health Reform on Systems of Care for Autism Spectrum Disorder and Other Developmental Disabilities

·         Evidence-based Approaches to Teen Pregnancy Prevention

·         AMCHP’s Autism Grantee Peer-to-Peer Exchange Program

  • Sudden Unexpected Infant Death (SUID): Research, Success and Challenges
  • New Research into Sudden Infant Death: Unraveling the Mystery of SIDS
  • Opportunities in Health Reform to Prevent Infant Death
  • Addressing Racial Disparities in Infant Sleep Practice: New Perspectives and Recommendations

·         All Member Call: Needs Assessment

·         National Stakeholders Meeting Reconvene State Cross Sharing Call

·         Preconception Health and Adolescents ALC State Cross Sharing Call

Publications and Peer Review Journal Articles (11 resources)  

·         Assessment of State Measures of Risk-Appropriate Care for Very Low Birth Weight Infants and Recommendations for Enhancing Regionalized State Systems. Maternal and Child Health Journal

·         Making the Case: A Comprehensive Systems Approach to Adolescent Health and Well-Being, White Paper

·         National Stakeholders Collaborative Brochure

·         National Stakeholders Meeting Success Stories: California, Massachusetts, Michigan, and South Carolina

·         New adolescent health-related funding awards chart by state

·         Smoking Cessation Resource Guide

·         The Healthy Women, Healthy Babies Program: A Delaware Case Study

·         The State Maternal and Child Health/Title Agencies Support Breastfeeding: Surveillance and Programs, Journal of Breastfeeding Medicine 

·         State Birth Defects Performance Measures

·         State Profiles in Comprehensive Family Participation

·         Women’s Health Equity, Prevention Issue Brief

Trainings and Meetings (Over 500 participants)

  • Adolescent Reproductive & Sexual Health Disparities Summit
  • Adolescent Health Coordinator Strategic Planning Meeting

·         Applied Multi-Level Modeling for MCH EPI Data Analysis

  • CYSHCN Envision 2020 Planning Meeting
  • Getting the Word out: Writing Effective Abstracts, Manuscripts and MCH EPI Issues Briefs

·         GIS methods for Public Health Professionals

·         Leadership Training for MCH Epidemiology / Public Health Professionals

  • Maternal and Child Health & Chronic Disease Collaboration Project

·         Making the Call to Improve Pregnancy Outcomes: A Focus on Tobacco Cessation Quitlines and HIV Hotlines

  • National Stakeholders Meeting 2.0 in Texas and North Dakota
  • New Adolescent Health Coordinator Orientation

·         Pandemic Influenza Revisited: Special Considerations for Pregnant Women and Newborns

·         State MCH Data Records Linkage Practice: Methodological Approaches

·         Using CDC’s Online Data for Epidemiologic Research Systems to Access PRAMS Data on Key Maternal and Child Health Indicators

National Conference Presentations (13 presentations)

·         Adolescent Health: Connecting the Dots between Data, Disparities, AMCHP Conference

·         Comprehensive Systems Approach to Adolescent Health, AMCHP Conference

·         Preconception Health for Adolescents, Really?!, CityMatCH conference

·         Regional Variations in Outcomes for Very Low Birth Weight Babies, National Perinatal Association Conference

·         Shaping the future of SIDS/SUIDS Programs,  AMCHP Conference

·         State Public Health Coordinating Center for Autism, Act Early Region Summits in Regions I and X

·         Strengthening state health and education agency partnerships to prevent HIV, STD, and pregnancy among school-aged youth, American Public Health Association Annual Conference

·         The Role of Title V in Breastfeeding Promotion,  Academy of Breastfeeding Medicine Annual Meeting

·         Using Data to Guide Policy: 10 Things Every Epidemiologist Should Know When Talking to Policymakers, MCH EPI conference

·         Using Evidence Based Approaches to Promote Adolescent Sexual Health , Alaska MCH Statewide Conference

 

Support Grants (10)

·         Collaborative efforts between health and education agencies to improve HIV, STD, and teen pregnancy prevention programs for youth

·         Preconception Health and Adolescents

 

State Technical Assistance Site Visits and Calls (6)

·         Support for the Pennsylvania Preconception Health Team

·         Support for the Ohio Preconception Health Team

·         Strategic planning and MCH conference in Alaska

·         Utah Autism Waiver Call

·         Alaska Peer-to-Peer Exchange

·         Missouri Peer-to-Peer Exchange

 

The Year Ahead: Program Team in 2011

 The Program Team has a lot planned for 2011! The following are highlights of the activities and initiatives that will be coming your way:

·         A call for applications for the 2012 New Director Mentor Program - new efforts to strengthen Family Delegate engagement in AMCHP

·         Expanded partnerships with family organizations

·         A call for applications for the 2012 Family Scholars Program

·         The Preconception Health Symposium: Extending Our Reach to Adolescents and Young Adults at the AMCHP Annual Conference

·         A Policy Framework to help states determine appropriate roles and approaches to take in building, improving and sustaining their system of care for children and youth with Autism Spectrum Disorders and their families

·         Recruitment of at least one best practice from every state and territory

·         New Peer-to-Peer Exchanges around Autism Spectrum Disorders

  • A Toolkit from the State Infant Mortality Collaborative to help states better investigate infant death
  • Ongoing work with CityMatCH to build state and local health department capacity to implement the life course perspective, including a life course town hall meeting at the AMCHP Annual Conference
  • Partnership with the American College of Obstetricians and Gynecologists (ACOG) to assess national and state factors that support the establishment and sustainability of state maternal mortality review committees
  • New training opportunities in MCH epidemiology and using data to influence programs and policies